05D2145928 CLIA NUMBER - ST. GEORGE'S MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 05D2145928

Facility Name: ST. GEORGE'S MEDICAL CLINIC

Facility Address:
1750 E COLORADO BLVD
PASADENA, CA
ZIP 91106
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Facility Phone Number: 626 440-0097

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689682544

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D2145928
LAB Type	Physician Office
Facility Name	ST. GEORGE'S MEDICAL CLINIC
Street	1750 E COLORADO BLVD
City	PASADENA
State	CA
ZIP	91106
Phone	626 440-0097
CertificateType	4
CertificateEffectiveDate	3/19/2024
CertificateExpirationDate	3/18/2026
FacilityType	Waiver

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