05D2048526 CLIA NUMBER - TOTAL CARE MEDICAL CLINIC ,

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Laboratory Demographics

CLIA Number: 05D2048526

Facility Name: TOTAL CARE MEDICAL CLINIC ,

Facility Address:
1110 W ANAHEIM ST STE 6
WILMINGTON, CA
ZIP 90744
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Facility Phone Number: 310 872-3560

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1801154463

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2048526
LAB Type	Community Clinic
Facility Name	TOTAL CARE MEDICAL CLINIC ,
Street	1110 W ANAHEIM ST STE 6
City	WILMINGTON
State	CA
ZIP	90744
Phone	310 872-3560
CertificateType	4
CertificateEffectiveDate	10/17/2022
CertificateExpirationDate	10/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024