05D0547259 CLIA NUMBER - MAHESH BHUTA MD

Laboratory Demographics

  • CLIA Code: 05D0547259
  • Facility Name: MAHESH BHUTA MD
  • Facility Address: 9711 VENICE BLVD
    LOS ANGELES, CA
    ZIP 90034
  • Facility Phone: 310 559-9884
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAHESH BHUTA
  • NPI Number: 1649305475
  • Taxonomy: 207RA0401X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0547259
LAB Type Physician Office
Facility Name MAHESH BHUTA MD
Street 9711 VENICE BLVD
City LOS ANGELES
State CA
ZIP 90034
Phone 310 559-9884
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Physician Office
Lab Director MAHESH BHUTA

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