05D2322079 CLIA NUMBER - HARRISON HASANUDDIN, D O, INC

Laboratory Demographics

  • CLIA Code: 05D2322079
  • Facility Name: HARRISON HASANUDDIN, D O, INC
  • Facility Address: 420 NORTH GARFIELD AVENUE, SUITE 203, MONTEREY PARK, CA 9
    MONTEREY PARK, CA
    ZIP 91754
  • Facility Phone: 626 763-1899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HARRISON HASANUDDIN
  • NPI Number: 1790165785
  • Taxonomy: 207QS1201X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2322079
LAB Type Physician Office
Facility Name HARRISON HASANUDDIN, D O, INC
Street 420 NORTH GARFIELD AVENUE, SUITE 203, MONTEREY PARK, CA 9
City MONTEREY PARK
State CA
ZIP 91754
Phone 626 763-1899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Physician Office
Lab Director HARRISON HASANUDDIN

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