05D1107548 CLIA NUMBER - HEMATECK LLC

Laboratory Demographics

  • CLIA Code: 05D1107548
  • Facility Name: HEMATECK LLC
  • Facility Address: 752 N LOREN AVE
    AZUSA, CA
    ZIP 91702
  • Facility Phone: 626 334-2000
  • Facility Type: Other - PATHOLOGY LABORATORY
  • Facility Type: Certificate of Compliance
  • Lab Director: MICHAEL R. BASTIEN
  • NPI Number: 1083870679
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D1107548
LAB Type Other - PATHOLOGY LABORATORY
Facility Name HEMATECK LLC
Street 752 N LOREN AVE
City AZUSA
State CA
ZIP 91702
Phone 626 334-2000
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/4/2022
Certificate Expiration Date 10/31/2025
Facility Type Other - PATHOLOGY LABORATORY
Lab Director MICHAEL R. BASTIEN

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