05D2109296 CLIA NUMBER - WESLEY HEALTH CENTERS AT ANDREW ESCAJEDA

Laboratory Demographics

CLIA Number: 05D2109296

Facility Name: WESLEY HEALTH CENTERS AT ANDREW ESCAJEDA

Facility Address:
1845 N FAIR OAKS AVE
PASADENA, CA
ZIP 91103
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Facility Phone Number: 323 201-4516

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1346423787

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2109296
LAB Type	Federally Qualified Health Center
Facility Name	WESLEY HEALTH CENTERS AT ANDREW ESCAJEDA
Street	1845 N FAIR OAKS AVE
City	PASADENA
State	CA
ZIP	91103
Phone	323 201-4516
CertificateType	3
CertificateEffectiveDate	2/23/2024
CertificateExpirationDate	2/22/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024