05D1081110 CLIA NUMBER - ALTAMED MEDICAL GROUP - PICO RIVERA PASSONS

Laboratory Demographics

  • CLIA Code: 05D1081110
  • Facility Name: ALTAMED MEDICAL GROUP - PICO RIVERA PASSONS
  • Facility Address: 6336 S PASSONS BLVD
    PICO RIVERA, CA
    ZIP 90660
  • Facility Phone: 562 205-4382
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: RAUL BARRERA
  • NPI Number: 1710191283
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1081110
LAB Type Federally Qualified Health Center
Facility Name ALTAMED MEDICAL GROUP - PICO RIVERA PASSONS
Street 6336 S PASSONS BLVD
City PICO RIVERA
State CA
ZIP 90660
Phone 562 205-4382
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Federally Qualified Health Center
Lab Director RAUL BARRERA

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