05D1106963 CLIA NUMBER - ALTAMED MEDICAL & DENTAL GROUP SANTA ANA MAIN

Laboratory Demographics

  • CLIA Code: 05D1106963
  • Facility Name: ALTAMED MEDICAL & DENTAL GROUP SANTA ANA MAIN
  • Facility Address: 1400 N MAIN ST
    SANTA ANA, CA
    ZIP 92701
  • Facility Phone: 714 352-7314
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DR. JASON YANG
  • NPI Number: 1740427657
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1106963
LAB Type Federally Qualified Health Center
Facility Name ALTAMED MEDICAL & DENTAL GROUP SANTA ANA MAIN
Street 1400 N MAIN ST
City SANTA ANA
State CA
ZIP 92701
Phone 714 352-7314
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Federally Qualified Health Center
Lab Director DR. JASON YANG

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