05D2057781 CLIA NUMBER - HOAG MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D2057781
  • Facility Name: HOAG MEDICAL GROUP
  • Facility Address: 510 SUPERIOR AVE STE. 200B
    NEWPORT BEACH, CA
    ZIP 92663
  • Facility Phone: 949 791-3065
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRA SAFER
  • NPI Number: 1558611632
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2057781
LAB Type Physician Office
Facility Name HOAG MEDICAL GROUP
Street 510 SUPERIOR AVE STE. 200B
City NEWPORT BEACH
State CA
ZIP 92663
Phone 949 791-3065
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Physician Office
Lab Director TERRA SAFER

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This page was last updated on: 6/4/2025