05D1093160 CLIA NUMBER - TIMOTHY J FERGUSON, MD INC

Laboratory Demographics

  • CLIA Code: 05D1093160
  • Facility Name: TIMOTHY J FERGUSON, MD INC
  • Facility Address: 210 S GRAND AVE STE 400
    GLENDORA, CA
    ZIP 91741
  • Facility Phone: 626 335-3527
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY J. FERGUSON, MD
  • NPI Number: 1205878451
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1093160
LAB Type Physician Office
Facility Name TIMOTHY J FERGUSON, MD INC
Street 210 S GRAND AVE STE 400
City GLENDORA
State CA
ZIP 91741
Phone 626 335-3527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Physician Office
Lab Director TIMOTHY J. FERGUSON, MD

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