05D2013915 CLIA NUMBER - PATRICK T PAN, MD INC

Laboratory Demographics

  • CLIA Code: 05D2013915
  • Facility Name: PATRICK T PAN, MD INC
  • Facility Address: 351 HOSPITAL ROAD, STE 407
    NEWPORT BEACH, CA
    ZIP 92663
  • Facility Phone: 949 200-7307
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICK T. PAN
  • NPI Number: 1922057587
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2013915
LAB Type Physician Office
Facility Name PATRICK T PAN, MD INC
Street 351 HOSPITAL ROAD, STE 407
City NEWPORT BEACH
State CA
ZIP 92663
Phone 949 200-7307
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director PATRICK T. PAN

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