05D2258471 CLIA NUMBER - WAVE MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D2258471
  • Facility Name: WAVE MEDICAL GROUP INC
  • Facility Address: 720 PAULARINO AVE, STE 102
    COSTA MESA, CA
    ZIP 92626
  • Facility Phone: 213 383-4800
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: PETER G. LEE
  • NPI Number: 1306328265
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 05D2258471
LAB Type Physician Office
Facility Name WAVE MEDICAL GROUP INC
Street 720 PAULARINO AVE, STE 102
City COSTA MESA
State CA
ZIP 92626
Phone 213 383-4800
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Physician Office
Lab Director PETER G. LEE

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