05D2058351 CLIA NUMBER - SREEDHAR CHAVA MD INC

Laboratory Demographics

  • CLIA Code: 05D2058351
  • Facility Name: SREEDHAR CHAVA MD INC
  • Facility Address: 1651 N HACIENDA BLVD
    LA PUENTE, CA
    ZIP 91744
  • Facility Phone: 626 917-8700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHAVA SREEDHAR
  • NPI Number: 1104163781
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2058351
LAB Type Physician Office
Facility Name SREEDHAR CHAVA MD INC
Street 1651 N HACIENDA BLVD
City LA PUENTE
State CA
ZIP 91744
Phone 626 917-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2024
Certificate Expiration Date 2/18/2026
Facility Type Physician Office
Lab Director CHAVA SREEDHAR

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