05D2091525 CLIA NUMBER - MONROVIA INTERNAL MEDICINE AND PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 05D2091525
  • Facility Name: MONROVIA INTERNAL MEDICINE AND PRIMARY CARE
  • Facility Address: 1227 BUENA VISTA ST STE F
    DUARTE, CA
    ZIP 91010
  • Facility Phone: 877 254-4496
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ULIN A. SARGEANT
  • NPI Number: 1407291347
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2091525
LAB Type Physician Office
Facility Name MONROVIA INTERNAL MEDICINE AND PRIMARY CARE
Street 1227 BUENA VISTA ST STE F
City DUARTE
State CA
ZIP 91010
Phone 877 254-4496
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Physician Office
Lab Director ULIN A. SARGEANT

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