05D2237823 CLIA NUMBER - MOHAMMED KHAN MD INC DBA HEAL 360

Laboratory Demographics

CLIA Number: 05D2237823

Facility Name: MOHAMMED KHAN MD INC DBA HEAL 360

Facility Address:
8100 GARDEN GROVE BLVD
GARDEN GROVE, CA
ZIP 92844
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Facility Phone Number: 951 343-1978

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1912008087

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D2237823
LAB Type	Physician Office
Facility Name	MOHAMMED KHAN MD INC DBA HEAL 360
Street	8100 GARDEN GROVE BLVD
City	GARDEN GROVE
State	CA
ZIP	92844
Phone	951 343-1978
CertificateType	4
CertificateEffectiveDate	9/28/2023
CertificateExpirationDate	9/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024