05D1052087 CLIA NUMBER - EDWARD MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D1052087
  • Facility Name: EDWARD MEDICAL GROUP INC
  • Facility Address: 12828 HARBOR BLVD 230
    GARDEN GROVE, CA
    ZIP 92840
  • Facility Phone: 714 741-4900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDWARD C. PYUNE
  • NPI Number: 1841486560
  • Taxonomy: 171M00000X - Case Manager/Care Coordinator

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CLIA Record

Field Name Field Value
CLIA Number 05D1052087
LAB Type Physician Office
Facility Name EDWARD MEDICAL GROUP INC
Street 12828 HARBOR BLVD 230
City GARDEN GROVE
State CA
ZIP 92840
Phone 714 741-4900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2024
Certificate Expiration Date 3/15/2026
Facility Type Physician Office
Lab Director EDWARD C. PYUNE

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