05D2074968 CLIA NUMBER - OC URGENTCARE MEDICAL GROUP INC

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Laboratory Demographics

CLIA Number: 05D2074968

Facility Name: OC URGENTCARE MEDICAL GROUP INC

Facility Address:
4720 E CHAPMAN AVE
ORANGE, CA
ZIP 92869
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Facility Phone Number: 714 698-8761

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1326581901

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2074968
LAB Type	Physician Office
Facility Name	OC URGENTCARE MEDICAL GROUP INC
Street	4720 E CHAPMAN AVE
City	ORANGE
State	CA
ZIP	92869
Phone	714 698-8761
CertificateType	4
CertificateEffectiveDate	3/19/2024
CertificateExpirationDate	3/18/2026
FacilityType	Waiver

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