05D2269185 CLIA NUMBER - FAMILY CARE CENTERS - URGENT CARE

Laboratory Demographics

CLIA Number: 05D2269185

Facility Name: FAMILY CARE CENTERS - URGENT CARE

Facility Address:
660 BAKER STREET, SUITE A-102
COSTA MESA, CA
ZIP 92626
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Facility Phone Number: 714 668-2505

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558312470

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2269185
LAB Type	Physician Office
Facility Name	FAMILY CARE CENTERS - URGENT CARE
Street	660 BAKER STREET, SUITE A-102
City	COSTA MESA
State	CA
ZIP	92626
Phone	714 668-2505
CertificateType	4
CertificateEffectiveDate	9/21/2022
CertificateExpirationDate	9/20/2024
FacilityType	Waiver

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