05D1092171 CLIA NUMBER - HUNTINGTON GERIATRIC MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D1092171

Facility Name: HUNTINGTON GERIATRIC MEDICAL GROUP

Facility Address:
2100 E COLORADO BLVD STE 1
PASADENA, CA
ZIP 91107
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Facility Phone Number: 626 229-9865

Facility Type: Health Main. Organization

Certificate Type: Waiver

NPI Number: 1265627277

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	05D1092171
LAB Type	Health Main. Organization
Facility Name	HUNTINGTON GERIATRIC MEDICAL GROUP
Street	2100 E COLORADO BLVD STE 1
City	PASADENA
State	CA
ZIP	91107
Phone	626 229-9865
CertificateType	4
CertificateEffectiveDate	11/18/2022
CertificateExpirationDate	11/17/2024
FacilityType	Waiver

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