05D2010872 CLIA NUMBER - PAUL SUCGANG DO INC

Laboratory Demographics

  • CLIA Code: 05D2010872
  • Facility Name: PAUL SUCGANG DO INC
  • Facility Address: 207 S SANTA ANITA ST, STE G18
    SAN GABRIEL, CA
    ZIP 91776
  • Facility Phone: 626 389-8448
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL SUCGANG
  • NPI Number: 1205843711
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2010872
LAB Type Physician Office
Facility Name PAUL SUCGANG DO INC
Street 207 S SANTA ANITA ST, STE G18
City SAN GABRIEL
State CA
ZIP 91776
Phone 626 389-8448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2023
Certificate Expiration Date 10/9/2025
Facility Type Physician Office
Lab Director PAUL SUCGANG

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