05D0541968 CLIA NUMBER - RANDALL G SHUE DO

Laboratory Demographics

  • CLIA Code: 05D0541968
  • Facility Name: RANDALL G SHUE DO
  • Facility Address: 4055 EAST OLYMPIC BOULEVARD SUITE 210
    LOS ANGELES, CA
    ZIP 90023
  • Facility Phone: 213 268-3491
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RANDALL SHUE
  • NPI Number: 1679576730
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0541968
LAB Type Physician Office
Facility Name RANDALL G SHUE DO
Street 4055 EAST OLYMPIC BOULEVARD SUITE 210
City LOS ANGELES
State CA
ZIP 90023
Phone 213 268-3491
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director RANDALL SHUE

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