05D2006413 CLIA NUMBER - OC URGENT CARE MEDICAL GROUP INC

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Laboratory Demographics

CLIA Number: 05D2006413

Facility Name: OC URGENT CARE MEDICAL GROUP INC

Facility Address:
631 S BROOKHURST ST STE 101
ANAHEIM, CA
ZIP 92804
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Facility Phone Number: 714 991-5700

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1578137618

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2006413
LAB Type	Other - URGENT CARE
Facility Name	OC URGENT CARE MEDICAL GROUP INC
Street	631 S BROOKHURST ST STE 101
City	ANAHEIM
State	CA
ZIP	92804
Phone	714 991-5700
CertificateType	4
CertificateEffectiveDate	10/5/2023
CertificateExpirationDate	10/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024