05D2045519 CLIA NUMBER - PATH MD

Laboratory Demographics

  • CLIA Code: 05D2045519
  • Facility Name: PATH MD
  • Facility Address: 20984 BAKE PKWY STE 106A
    LAKE FOREST, CA
    ZIP 92630
  • Facility Phone: 424 245-7284
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. ASHLEY TARASEN
  • NPI Number: 1124316138
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D2045519
LAB Type Independent
Facility Name PATH MD
Street 20984 BAKE PKWY STE 106A
City LAKE FOREST
State CA
ZIP 92630
Phone 424 245-7284
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Independent
Lab Director DR. ASHLEY TARASEN

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