05D1090909 CLIA NUMBER - IRVINE PATHOLOGY MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D1090909

Facility Name: IRVINE PATHOLOGY MEDICAL GROUP INC

Facility Address:
15375 BARRANCA PKWY STE H-105
IRVINE, CA
ZIP 92618
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Facility Phone Number: 949 387-8111

Facility Type: Independent

Certificate Type: Certificate of Compliance

NPI Number: 1619077724

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D1090909
LAB Type	Independent
Facility Name	IRVINE PATHOLOGY MEDICAL GROUP INC
Street	15375 BARRANCA PKWY STE H-105
City	IRVINE
State	CA
ZIP	92618
Phone	949 387-8111
CertificateType	2
CertificateEffectiveDate	8/18/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024