05D2131787 CLIA NUMBER - FOOTHILL CARDIOLOGY MEDICAL GROUP, INC

Laboratory Demographics

  • CLIA Code: 05D2131787
  • Facility Name: FOOTHILL CARDIOLOGY MEDICAL GROUP, INC
  • Facility Address: 289 W HUNTINGTON DR STE 401
    ARCADIA, CA
    ZIP 91007
  • Facility Phone: 626 254-0074
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAIME HENRIQUEZ MD
  • NPI Number: 1518329408
  • Taxonomy: 207K00000X - Allergy & Immunology

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CLIA Record

Field Name Field Value
CLIA Number 05D2131787
LAB Type Physician Office
Facility Name FOOTHILL CARDIOLOGY MEDICAL GROUP, INC
Street 289 W HUNTINGTON DR STE 401
City ARCADIA
State CA
ZIP 91007
Phone 626 254-0074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2023
Certificate Expiration Date 6/5/2025
Facility Type Physician Office
Lab Director JAIME HENRIQUEZ MD

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