05D1055110 CLIA NUMBER - PAUL TC LIU MD

Laboratory Demographics

  • CLIA Code: 05D1055110
  • Facility Name: PAUL TC LIU MD
  • Facility Address: 2233 HUNTINGTON DR STE 12
    SAN MARINO, CA
    ZIP 91108
  • Facility Phone: 626 796-0821
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL T. LIU
  • NPI Number: 1295934792
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D1055110
LAB Type Physician Office
Facility Name PAUL TC LIU MD
Street 2233 HUNTINGTON DR STE 12
City SAN MARINO
State CA
ZIP 91108
Phone 626 796-0821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2024
Certificate Expiration Date 6/7/2026
Facility Type Physician Office
Lab Director PAUL T. LIU

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