05D2230664 CLIA NUMBER - PHANTOM MEDICAL, INC

Laboratory Demographics

  • CLIA Code: 05D2230664
  • Facility Name: PHANTOM MEDICAL, INC
  • Facility Address: 1240 E CHAPMAN AVE SUITE A
    ORANGE, CA
    ZIP 92866
  • Facility Phone: 714 771-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NEAL H. PATEL
  • NPI Number: 1790390052
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2230664
LAB Type Physician Office
Facility Name PHANTOM MEDICAL, INC
Street 1240 E CHAPMAN AVE SUITE A
City ORANGE
State CA
ZIP 92866
Phone 714 771-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2025
Certificate Expiration Date 7/26/2027
Facility Type Physician Office
Lab Director NEAL H. PATEL

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