05D1030503 CLIA NUMBER - ABRAHAM CHEN DO INC

Laboratory Demographics

CLIA Number: 05D1030503

Facility Name: ABRAHAM CHEN DO INC

Facility Address:
10995 EUCALYPTUS ST STE 102
RANCHO CUCAMONGA, CA
ZIP 91730
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Facility Phone Number: 909 466-6310

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942488101

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D1030503
LAB Type	Physician Office
Facility Name	ABRAHAM CHEN DO INC
Street	10995 EUCALYPTUS ST STE 102
City	RANCHO CUCAMONGA
State	CA
ZIP	91730
Phone	909 466-6310
CertificateType	4
CertificateEffectiveDate	9/8/2022
CertificateExpirationDate	9/7/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024