05D2316906 CLIA NUMBER - COMMONWEALTH REHAB LLC

Laboratory Demographics

  • CLIA Code: 05D2316906
  • Facility Name: COMMONWEALTH REHAB LLC
  • Facility Address: 515 W COMMONWEALTH AVE #211
    FULLERTON, CA
    ZIP 92832
  • Facility Phone: 310 343-8684
  • Facility Type: Other - IOP
  • Facility Type: Waiver
  • Lab Director: JISEUNG YOON
  • NPI Number: 1730873548
  • Taxonomy: 101YA0400X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 05D2316906
LAB Type Other - IOP
Facility Name COMMONWEALTH REHAB LLC
Street 515 W COMMONWEALTH AVE #211
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 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Other - IOP
Lab Director JISEUNG YOON

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