05D2108548 CLIA NUMBER - WENCHENG JEN

Laboratory Demographics

  • CLIA Code: 05D2108548
  • Facility Name: WENCHENG JEN
  • Facility Address: 416 W LAS TUNAS DR STE 305
    SAN GABRIEL, CA
    ZIP 91776
  • Facility Phone: 626 416-3051
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WENCHENG JEN, MD
  • NPI Number: 1811915481
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2108548
LAB Type Physician Office
Facility Name WENCHENG JEN
Street 416 W LAS TUNAS DR STE 305
City SAN GABRIEL
State CA
ZIP 91776
Phone 626 416-3051
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Physician Office
Lab Director WENCHENG JEN, MD

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