05D1047067 CLIA NUMBER - LORI J IZABAL MD A PROFESSIONAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D1047067
  • Facility Name: LORI J IZABAL MD A PROFESSIONAL CORPORATION
  • Facility Address: 1401 AVOCADO AVE, STE 608
    NEWPORT BEACH, CA
    ZIP 92660
  • Facility Phone: 949 640-4455
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORI J. IZABAL
  • NPI Number: 1114992328
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1047067
LAB Type Physician Office
Facility Name LORI J IZABAL MD A PROFESSIONAL CORPORATION
Street 1401 AVOCADO AVE, STE 608
City NEWPORT BEACH
State CA
ZIP 92660
Phone 949 640-4455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Physician Office
Lab Director LORI J. IZABAL

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This page was last updated on: 9/29/2025