05D1098803 CLIA NUMBER - VALERIA I KOZAK, MD

Laboratory Demographics

  • CLIA Code: 05D1098803
  • Facility Name: VALERIA I KOZAK, MD
  • Facility Address: 17400 IRVINE BLVD #J
    TUSTIN, CA
    ZIP 92780
  • Facility Phone: 714 838-0022
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VALERIA I. KOZAK
  • NPI Number: 1720057516
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1098803
LAB Type Physician Office
Facility Name VALERIA I KOZAK, MD
Street 17400 IRVINE BLVD #J
City TUSTIN
State CA
ZIP 92780
Phone 714 838-0022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Physician Office
Lab Director VALERIA I. KOZAK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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