05D0545816 CLIA NUMBER - TIMOTHY C REYNOLDS, MD INC

Laboratory Demographics

  • CLIA Code: 05D0545816
  • Facility Name: TIMOTHY C REYNOLDS, MD INC
  • Facility Address: 11645 WILSHIRE BLVD, STE 988
    LOS ANGELES, CA
    ZIP 90025
  • Facility Phone: 310 478-1188
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY C. REYNOLDS
  • NPI Number: 1053324608
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0545816
LAB Type Physician Office
Facility Name TIMOTHY C REYNOLDS, MD INC
Street 11645 WILSHIRE BLVD, STE 988
City LOS ANGELES
State CA
ZIP 90025
Phone 310 478-1188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2023
Certificate Expiration Date 9/2/2025
Facility Type Physician Office
Lab Director TIMOTHY C. REYNOLDS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025