05D0543719 CLIA NUMBER - PRIVILEGE DX MEDICAL LABORATORIES, INC

Laboratory Demographics

  • CLIA Code: 05D0543719
  • Facility Name: PRIVILEGE DX MEDICAL LABORATORIES, INC
  • Facility Address: 10133 RIVERSIDE DR
    TOLUCA LAKE, CA
    ZIP 91602
  • Facility Phone: 747 203-1614
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: SHIRLEY Z. TAN, MD
  • NPI Number: 1003369968
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D0543719
LAB Type Independent
Facility Name PRIVILEGE DX MEDICAL LABORATORIES, INC
Street 10133 RIVERSIDE DR
City TOLUCA LAKE
State CA
ZIP 91602
Phone 747 203-1614
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/15/2021
Certificate Expiration Date 10/31/2025
Facility Type Independent
Lab Director SHIRLEY Z. TAN, MD

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