05D2051307 CLIA NUMBER - PACIFIC URGENT CARE & FAMILY MEDICINE

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Laboratory Demographics

CLIA Number: 05D2051307

Facility Name: PACIFIC URGENT CARE & FAMILY MEDICINE

Facility Address:
1520 E LINCOLN AVE
ORANGE, CA
ZIP 92865
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Facility Phone Number: 714 921-3870

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1831452820

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2051307
LAB Type	Physician Office
Facility Name	PACIFIC URGENT CARE & FAMILY MEDICINE
Street	1520 E LINCOLN AVE
City	ORANGE
State	CA
ZIP	92865
Phone	714 921-3870
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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