05D2205722 CLIA NUMBER - MEDICAL ALLIANCE GROUP

Laboratory Demographics

  • CLIA Code: 05D2205722
  • Facility Name: MEDICAL ALLIANCE GROUP
  • Facility Address: 1528 CANADA BLVD SUITE 203
    GLENDALE, CA
    ZIP 91208
  • Facility Phone: 747 274-2450
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: PHILIP KIM
  • NPI Number: 1447869334
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2205722
LAB Type Home Health Agency
Facility Name MEDICAL ALLIANCE GROUP
Street 1528 CANADA BLVD SUITE 203
City GLENDALE
State CA
ZIP 91208
Phone 747 274-2450
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Home Health Agency
Lab Director PHILIP KIM

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