05D2050937 CLIA NUMBER - ELLEN MCDONALD MD INC

Laboratory Demographics

  • CLIA Code: 05D2050937
  • Facility Name: ELLEN MCDONALD MD INC
  • Facility Address: 800 FAIRMOUNT AVE STE 210
    PASADENA, CA
    ZIP 91105
  • Facility Phone: 626 872-4195
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLEN K. MCDONALD
  • NPI Number: 1679751408
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2050937
LAB Type Physician Office
Facility Name ELLEN MCDONALD MD INC
Street 800 FAIRMOUNT AVE STE 210
City PASADENA
State CA
ZIP 91105
Phone 626 872-4195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Physician Office
Lab Director ELLEN K. MCDONALD

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