05D2258528 CLIA NUMBER - YEYONGSHINDO INC

Laboratory Demographics

  • CLIA Code: 05D2258528
  • Facility Name: YEYONGSHINDO INC
  • Facility Address: 1111 GRAND AVENUE, SUITE J
    DIAMOND BAR, CA
    ZIP 91765
  • Facility Phone: 909 895-7735
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YEYONG SHIN
  • NPI Number: 1215508247
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2258528
LAB Type Physician Office
Facility Name YEYONGSHINDO INC
Street 1111 GRAND AVENUE, SUITE J
City DIAMOND BAR
State CA
ZIP 91765
Phone 909 895-7735
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director YEYONG SHIN

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