05D0547880 CLIA NUMBER - ANANIAS E EBILANE MD

Laboratory Demographics

  • CLIA Code: 05D0547880
  • Facility Name: ANANIAS E EBILANE MD
  • Facility Address: 13429 S HAWTHORNE BLVD
    HAWTHORNE, CA
    ZIP 90250
  • Facility Phone: 310 644-8683
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANANIAS E. EBILANE
  • NPI Number: 1265611362
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0547880
LAB Type Physician Office
Facility Name ANANIAS E EBILANE MD
Street 13429 S HAWTHORNE BLVD
City HAWTHORNE
State CA
ZIP 90250
Phone 310 644-8683
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ANANIAS E. EBILANE

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