05D2224790 CLIA NUMBER - PROSTATYPE GENOMICS, INC

Laboratory Demographics

  • CLIA Code: 05D2224790
  • Facility Name: PROSTATYPE GENOMICS, INC
  • Facility Address: 5 MASON LN STE 190
    IRVINE, CA
    ZIP 92618
  • Facility Phone: 949 297-3984
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. PETROS GIANNIKOPOULOS
  • NPI Number: 1457187296
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2224790
LAB Type Independent
Facility Name PROSTATYPE GENOMICS, INC
Street 5 MASON LN STE 190
City IRVINE
State CA
ZIP 92618
Phone 949 297-3984
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Independent
Lab Director DR. PETROS GIANNIKOPOULOS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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