05D2144610 CLIA NUMBER - WESTERN PACIFIC MED CORP

Laboratory Demographics

  • CLIA Code: 05D2144610
  • Facility Name: WESTERN PACIFIC MED CORP
  • Facility Address: 11902 ROSECRANS AVE STE A
    NORWALK, CA
    ZIP 90650
  • Facility Phone: 562 929-7188
  • Facility Type: Other - OPIOID TREATMNT PROGRAM
  • Facility Type: Waiver
  • Lab Director: RAGAA Z. ISKAROUS, MD
  • NPI Number: 1205275195
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2144610
LAB Type Other - OPIOID TREATMNT PROGRAM
Facility Name WESTERN PACIFIC MED CORP
Street 11902 ROSECRANS AVE STE A
City NORWALK
State CA
ZIP 90650
Phone 562 929-7188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Other - OPIOID TREATMNT PROGRAM
Lab Director RAGAA Z. ISKAROUS, MD

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