05D2273695 CLIA NUMBER - REDDY CARE MEDICAL AZUSA

Laboratory Demographics

  • CLIA Code: 05D2273695
  • Facility Name: REDDY CARE MEDICAL AZUSA
  • Facility Address: 459 S AZUSA AVE STE F
    AZUSA, CA
    ZIP 91702
  • Facility Phone: 909 623-4050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MALLU REDDY
  • NPI Number: 1447644182
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2273695
LAB Type Physician Office
Facility Name REDDY CARE MEDICAL AZUSA
Street 459 S AZUSA AVE STE F
City AZUSA
State CA
ZIP 91702
Phone 909 623-4050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Physician Office
Lab Director MALLU REDDY

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