05D2007572 CLIA NUMBER - FAMILY CARE CENTERS MEDICAL GROUP

Home > CLIA Lookup > 05D2007572

Laboratory Demographics

CLIA Number: 05D2007572

Facility Name: FAMILY CARE CENTERS MEDICAL GROUP

Facility Address:
1441 AVOCADO AVE SUITE 503
NEWPORT BEACH, CA
ZIP 92660
Get Directions

Facility Phone Number: 949 718-9020

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1134557655

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2007572
LAB Type	Physician Office
Facility Name	FAMILY CARE CENTERS MEDICAL GROUP
Street	1441 AVOCADO AVE SUITE 503
City	NEWPORT BEACH
State	CA
ZIP	92660
Phone	949 718-9020
CertificateType	3
CertificateEffectiveDate	5/19/2022
CertificateExpirationDate	5/18/2024
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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