05D2316050 CLIA NUMBER - BUENA PARK REHAB LLC

Laboratory Demographics

  • CLIA Code: 05D2316050
  • Facility Name: BUENA PARK REHAB LLC
  • Facility Address: 515 W COMMONWEALTH AVE #215
    FULLERTON, CA
    ZIP 92832
  • Facility Phone: 310 343-8684
  • Facility Type: Other - IOP
  • Facility Type: Waiver
  • Lab Director: JISEUNG YOON
  • NPI Number: 1346934247
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2316050
LAB Type Other - IOP
Facility Name BUENA PARK REHAB LLC
Street 515 W COMMONWEALTH AVE #215
City FULLERTON
State CA
ZIP 92832
Phone 310 343-8684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2024
Certificate Expiration Date 12/25/2026
Facility Type Other - IOP
Lab Director JISEUNG YOON

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