05D2110400 CLIA NUMBER - KENNETH W LEE MD & ASSOCIATES INC

Laboratory Demographics

  • CLIA Code: 05D2110400
  • Facility Name: KENNETH W LEE MD & ASSOCIATES INC
  • Facility Address: 210 W BONITA AVE STE 140
    POMONA, CA
    ZIP 91767
  • Facility Phone: 909 622-3800
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: ELLIE LEKOV MD
  • NPI Number: 1417023227
  • Taxonomy: 207RG0100X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2110400
LAB Type Physician Office
Facility Name KENNETH W LEE MD & ASSOCIATES INC
Street 210 W BONITA AVE STE 140
City POMONA
State CA
ZIP 91767
Phone 909 622-3800
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Physician Office
Lab Director ELLIE LEKOV MD

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