05D1043920 CLIA NUMBER - ALI R TAJIK

Laboratory Demographics

CLIA Number: 05D1043920

Facility Name: ALI R TAJIK

Facility Address:
3400 W BALL RD - #207
ANAHEIM, CA
ZIP 92804
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Facility Phone Number: 714 821-8519

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528285848

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	05D1043920
LAB Type	Physician Office
Facility Name	ALI R TAJIK
Street	3400 W BALL RD - #207
City	ANAHEIM
State	CA
ZIP	92804
Phone	714 821-8519
CertificateType	4
CertificateEffectiveDate	8/5/2023
CertificateExpirationDate	8/4/2025
FacilityType	Waiver

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