05D2000271 CLIA NUMBER - DEREK TRUONG PHAN, MD, INC

Laboratory Demographics

  • CLIA Code: 05D2000271
  • Facility Name: DEREK TRUONG PHAN, MD, INC
  • Facility Address: 10152 WESTMINSTER AVE STE 100
    GARDEN GROVE, CA
    ZIP 92843
  • Facility Phone: 714 530-3939
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEREK PHAN
  • NPI Number: 1598091837
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2000271
LAB Type Physician Office
Facility Name DEREK TRUONG PHAN, MD, INC
Street 10152 WESTMINSTER AVE STE 100
City GARDEN GROVE
State CA
ZIP 92843
Phone 714 530-3939
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Physician Office
Lab Director DEREK PHAN

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