05D2074367 CLIA NUMBER - JONATHAN OU, MD

Laboratory Demographics

  • CLIA Code: 05D2074367
  • Facility Name: JONATHAN OU, MD
  • Facility Address: 2707 S DIAMOND BAR BLVD STE 104
    DIAMOND BAR, CA
    ZIP 91765
  • Facility Phone: 909 594-8331
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JONATHAN OU, MD
  • NPI Number: 1518109719
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2074367
LAB Type Physician Office
Facility Name JONATHAN OU, MD
Street 2707 S DIAMOND BAR BLVD STE 104
City DIAMOND BAR
State CA
ZIP 91765
Phone 909 594-8331
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Physician Office
Lab Director JONATHAN OU, MD

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