05D1053177 CLIA NUMBER - BEAVER MEDICAL GROUP, LP /HIGHLAND OFFICE

Laboratory Demographics

  • CLIA Code: 05D1053177
  • Facility Name: BEAVER MEDICAL GROUP, LP /HIGHLAND OFFICE
  • Facility Address: 7000 BOULDER AVE
    HIGHLAND, CA
    ZIP 92346
  • Facility Phone: 562 988-7027
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL G. LEONG, MD
  • NPI Number: 1346278363
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1053177
LAB Type Physician Office
Facility Name BEAVER MEDICAL GROUP, LP /HIGHLAND OFFICE
Street 7000 BOULDER AVE
City HIGHLAND
State CA
ZIP 92346
Phone 562 988-7027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Physician Office
Lab Director MICHAEL G. LEONG, MD

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