05D2230306 CLIA NUMBER - UPPER ECHELON MEDICAL

Laboratory Demographics

  • CLIA Code: 05D2230306
  • Facility Name: UPPER ECHELON MEDICAL
  • Facility Address: 1440 N HARBOR BLVD SUITE 110
    FULLERTON, CA
    ZIP 92835
  • Facility Phone: 651 212-3212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN OEI
  • NPI Number: 1750032082
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2230306
LAB Type Physician Office
Facility Name UPPER ECHELON MEDICAL
Street 1440 N HARBOR BLVD SUITE 110
City FULLERTON
State CA
ZIP 92835
Phone 651 212-3212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Physician Office
Lab Director KEVIN OEI

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