05D1051243 CLIA NUMBER - LESTONNAC FREE CLINIC

Laboratory Demographics

CLIA Number: 05D1051243

Facility Name: LESTONNAC FREE CLINIC

Facility Address:
1215 E CHAPMAN AVE
ORANGE, CA
ZIP 92866
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Facility Phone Number: 714 583-6431

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1457724023

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	05D1051243
LAB Type	Community Clinic
Facility Name	LESTONNAC FREE CLINIC
Street	1215 E CHAPMAN AVE
City	ORANGE
State	CA
ZIP	92866
Phone	714 583-6431
CertificateType	4
CertificateEffectiveDate	10/2/2023
CertificateExpirationDate	10/1/2025
FacilityType	Waiver

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