09D1092357 CLIA NUMBER - MAMONLUK CHUA MEDICAL GROUP, PC

Laboratory Demographics

  • CLIA Code: 09D1092357
  • Facility Name: MAMONLUK CHUA MEDICAL GROUP, PC
  • Facility Address: 1160 VARNUM STREET NE ROOM #008
    WASHINGTON, DC
    ZIP 20017
  • Facility Phone: (202) 526-3897
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FERDINAND P. CHUA
  • NPI Number: 1295987436
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 09D1092357
LAB Type Physician Office
Facility Name MAMONLUK CHUA MEDICAL GROUP, PC
Street 1160 VARNUM STREET NE ROOM #008
City WASHINGTON
State DC
ZIP 20017
Phone 2025263897
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2024
Certificate Expiration Date 11/20/2026
Facility Type Physician Office
Lab Director FERDINAND P. CHUA

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This page was last updated on: 5/18/2026