05D2113742 CLIA NUMBER - RAYMUNDO M. GARCIA LORA, M.D. INC

Laboratory Demographics

CLIA Number: 05D2113742

Facility Name: RAYMUNDO M. GARCIA LORA, M.D. INC

Facility Address:
1920 E KATELLA AVE STE U
ORANGE, CA
ZIP 92867
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Facility Phone Number: 714 930-5818

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124474606

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2113742
LAB Type	Physician Office
Facility Name	RAYMUNDO M. GARCIA LORA, M.D. INC
Street	1920 E KATELLA AVE STE U
City	ORANGE
State	CA
ZIP	92867
Phone	714 930-5818
CertificateType	4
CertificateEffectiveDate	5/31/2022
CertificateExpirationDate	5/30/2024
FacilityType	Waiver

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