05D2029768 CLIA NUMBER - CARELON HEALTH

Laboratory Demographics

  • CLIA Code: 05D2029768
  • Facility Name: CARELON HEALTH
  • Facility Address: 301 N AZUSA AVE
    WEST COVINA, CA
    ZIP 91791
  • Facility Phone: 626 214-2600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KONDURI VINAYA
  • NPI Number: 1538532098
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 05D2029768
LAB Type Physician Office
Facility Name CARELON HEALTH
Street 301 N AZUSA AVE
City WEST COVINA
State CA
ZIP 91791
Phone 626 214-2600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Physician Office
Lab Director KONDURI VINAYA

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