05D2191041 CLIA NUMBER - ST. JOSEPH MULTI-SPECIALTY CLINIC CORP.

Laboratory Demographics

  • CLIA Code: 05D2191041
  • Facility Name: ST. JOSEPH MULTI-SPECIALTY CLINIC CORP.
  • Facility Address: 1557 EAST AMAR ROAD SUITE F
    WEST COVINA, CA
    ZIP 91792
  • Facility Phone: 626 839-9100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHURA ALEXIS MORENO
  • NPI Number: 1487286316
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2191041
LAB Type Physician Office
Facility Name ST. JOSEPH MULTI-SPECIALTY CLINIC CORP.
Street 1557 EAST AMAR ROAD SUITE F
City WEST COVINA
State CA
ZIP 91792
Phone 626 839-9100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2024
Certificate Expiration Date 8/20/2026
Facility Type Physician Office
Lab Director SHURA ALEXIS MORENO

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