05D2291536 CLIA NUMBER - MAMMOTH PATH SOLUTION, LLC

Laboratory Demographics

  • CLIA Code: 05D2291536
  • Facility Name: MAMMOTH PATH SOLUTION, LLC
  • Facility Address: 20505 CRESCENT BAY DR, STE A2
    LAKE FOREST, CA
    ZIP 92630
  • Facility Phone: 714 726-9565
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. ANDREW BURG
  • NPI Number: 1023883576
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2291536
LAB Type Independent
Facility Name MAMMOTH PATH SOLUTION, LLC
Street 20505 CRESCENT BAY DR, STE A2
City LAKE FOREST
State CA
ZIP 92630
Phone 714 726-9565
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 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Independent
Lab Director DR. ANDREW BURG

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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