05D2098850 CLIA NUMBER - MISSION CITY COMMUNITY NETWORK, INC - LA PUENTE

Laboratory Demographics

  • CLIA Code: 05D2098850
  • Facility Name: MISSION CITY COMMUNITY NETWORK, INC - LA PUENTE
  • Facility Address: 1025 WILLOW AVE
    LA PUENTE, CA
    ZIP 91746
  • Facility Phone: 818 895-3100
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: EDWARD WANG
  • NPI Number: 1467760165
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2098850
LAB Type Community Clinic
Facility Name MISSION CITY COMMUNITY NETWORK, INC - LA PUENTE
Street 1025 WILLOW AVE
City LA PUENTE
State CA
ZIP 91746
Phone 818 895-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Community Clinic
Lab Director EDWARD WANG

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