05D2121660 CLIA NUMBER - SANTA MARIA MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D2121660
  • Facility Name: SANTA MARIA MEDICAL CLINIC
  • Facility Address: 1701 E MCFADDEN AVE UNIT D
    SANTA ANA, CA
    ZIP 92705
  • Facility Phone: 714 953-6430
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAVEH KARANDISH
  • NPI Number: 1750831822
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D2121660
LAB Type Physician Office
Facility Name SANTA MARIA MEDICAL CLINIC
Street 1701 E MCFADDEN AVE UNIT D
City SANTA ANA
State CA
ZIP 92705
Phone 714 953-6430
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2024
Certificate Expiration Date 11/9/2026
Facility Type Physician Office
Lab Director KAVEH KARANDISH

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This page was last updated on: 6/4/2025