CLIA lab
CLIA 05D1063020: Chaewon Song MD Inc
Garden Grove, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1063020 belongs to Chaewon Song MD Inc in Garden Grove, CA.
Certificate of Waiver, effective January 3, 2025, expires January 2, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- January 3, 2025
- Certificate expiration
- January 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 3, 2007
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1063020
- Lab name
- Chaewon Song MD Inc
- Address
- 12665 Garden Grove Blvd #503, Garden Grove, CA 92843
- Phone
- (714) 530-3740
- Fax
- (714) 530-0582
Annual test volume the lab reported
- Waived tests
- 2,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- 365 Medical Group, Inc.Certificate of Waiver, Physician office05D2220592
- Advanced Center for Urology IncCertificate of Waiver, Physician office05D0577178
- Advanced Healthcare PharmacyCertificate of Waiver, Pharmacy05D2188715
- Alta Gardens Care CenterCertificate of Waiver, Skilled nursing or nursing facility05D0577163
- Alta Home Health Care Services IncCertificate of Waiver, Home health agency05D2283074
- Altamed Medical Group-Garden Grove HarborCertificate of Waiver, Community clinic05D1106763
- Bethel Medical Group, Inc.Certificate of Waiver, Physician office05D2147855
- Brookdale Garden GroveCertificate of Waiver, Assisted living facility05D2215464
- Brookdale Valley ViewCertificate of Waiver, Assisted living facility05D2215530
Related
Questions
What is the CLIA number for Chaewon Song MD Inc in Garden Grove?
05D1063020, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Chaewon Song MD Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1063020 expire?
The CMS file lists January 2, 2027 as the certificate expiration date; the certificate took effect January 3, 2025.