05D1080137 CLIA NUMBER - MINAL MEHTA, MD, A PROFESSIONAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D1080137
  • Facility Name: MINAL MEHTA, MD, A PROFESSIONAL CORPORATION
  • Facility Address: 18111 BROOKHURST ST STE 4450
    FOUNTAIN VALLEY, CA
    ZIP 92708
  • Facility Phone: 714 848-2383
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINAL G. MEHTA
  • NPI Number: 1780787580
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D1080137
LAB Type Physician Office
Facility Name MINAL MEHTA, MD, A PROFESSIONAL CORPORATION
Street 18111 BROOKHURST ST STE 4450
City FOUNTAIN VALLEY
State CA
ZIP 92708
Phone 714 848-2383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director MINAL G. MEHTA

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