05D2027011 CLIA NUMBER - THA CHA, MD

Laboratory Demographics

  • CLIA Code: 05D2027011
  • Facility Name: THA CHA, MD
  • Facility Address: 125 E BARSTOW AVE SUITE 118
    FRESNO, CA
    ZIP 93710
  • Facility Phone: 559 488-5290
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHA CHA
  • NPI Number: 1073547824
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 05D2027011
LAB Type Physician Office
Facility Name THA CHA, MD
Street 125 E BARSTOW AVE SUITE 118
City FRESNO
State CA
ZIP 93710
Phone 559 488-5290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Physician Office
Lab Director CHA CHA

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