05D1049366 CLIA NUMBER - ORANGE COUNTY UROLOGY ASSOCIATES

Laboratory Demographics

CLIA Number: 05D1049366

Facility Name: ORANGE COUNTY UROLOGY ASSOCIATES

Facility Address:
26691 PLAZA DR STE 120
MISSION VIEJO, CA
ZIP 92691
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Facility Phone Number: 949 855-1101

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154833408

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D1049366
LAB Type	Physician Office
Facility Name	ORANGE COUNTY UROLOGY ASSOCIATES
Street	26691 PLAZA DR STE 120
City	MISSION VIEJO
State	CA
ZIP	92691
Phone	949 855-1101
CertificateType	4
CertificateEffectiveDate	1/4/2024
CertificateExpirationDate	1/3/2026
FacilityType	Waiver

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