05D2109296 CLIA NUMBER - WESLEY HEALTH CENTERS AT ANDREW ESCAJEDA

Laboratory Demographics

  • CLIA Code: 05D2109296
  • Facility Name: WESLEY HEALTH CENTERS AT ANDREW ESCAJEDA
  • Facility Address: 1845 N FAIR OAKS AVE
    PASADENA, CA
    ZIP 91103
  • Facility Phone: 323 201-4516
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: PHILLIP LE
  • NPI Number: 1346423787
  • Taxonomy: 261QC1500X - Clinic/Center

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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
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Federally Qualified Health Center
Lab Director PHILLIP LE

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