05D2105057 CLIA NUMBER - ATIVA LLC

Laboratory Demographics

  • CLIA Code: 05D2105057
  • Facility Name: ATIVA LLC
  • Facility Address: 18022 COWAN SUITE 215
    IRVINE, CA
    ZIP 92614
  • Facility Phone: 949 225-2188
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MON TA TSAI
  • NPI Number: 1124413620
  • Taxonomy: 251E00000X - Home Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2105057
LAB Type Home Health Agency
Facility Name ATIVA LLC
Street 18022 COWAN SUITE 215
City IRVINE
State CA
ZIP 92614
Phone 949 225-2188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Home Health Agency
Lab Director MON TA TSAI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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