05D2287078 CLIA NUMBER - GNOSIS GERIATRIC WELLCARE CENTER INC

Laboratory Demographics

CLIA Number: 05D2287078

Facility Name: GNOSIS GERIATRIC WELLCARE CENTER INC

Facility Address:
12555 GARDEN GROVE BLVD, STE 304
GARDEN GROVE, CA
ZIP 92843
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Facility Phone Number: 714 353-5333

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1962145029

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D2287078
LAB Type	Physician Office
Facility Name	GNOSIS GERIATRIC WELLCARE CENTER INC
Street	12555 GARDEN GROVE BLVD, STE 304
City	GARDEN GROVE
State	CA
ZIP	92843
Phone	714 353-5333
CertificateType	4
CertificateEffectiveDate	8/8/2023
CertificateExpirationDate	8/7/2025
FacilityType	Waiver

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