05D2077779 CLIA NUMBER - ALEXANDER M BONAKDAR

Laboratory Demographics

  • CLIA Code: 05D2077779
  • Facility Name: ALEXANDER M BONAKDAR
  • Facility Address: 801 N TUSTIN AVE STE 404
    SANTA ANA, CA
    ZIP 92705
  • Facility Phone: 714 558-1182
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEXANDER M. BONAKDAR
  • NPI Number: 1588668917
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 05D2077779
LAB Type Physician Office
Facility Name ALEXANDER M BONAKDAR
Street 801 N TUSTIN AVE STE 404
City SANTA ANA
State CA
ZIP 92705
Phone 714 558-1182
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Physician Office
Lab Director ALEXANDER M. BONAKDAR

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