05D2179879 CLIA NUMBER - GRACE GERIATRIC CARE, INC

Laboratory Demographics

  • CLIA Code: 05D2179879
  • Facility Name: GRACE GERIATRIC CARE, INC
  • Facility Address: 8883 WESTMINSTER AVENUE
    GARDEN GROVE, CA
    ZIP 92844
  • Facility Phone: 657 208-2221
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROGER NGUYEN-TRAN
  • NPI Number: 1023652914
  • Taxonomy: 207QG0300X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2179879
LAB Type Physician Office
Facility Name GRACE GERIATRIC CARE, INC
Street 8883 WESTMINSTER AVENUE
City GARDEN GROVE
State CA
ZIP 92844
Phone 657 208-2221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Physician Office
Lab Director ROGER NGUYEN-TRAN

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