05D0553665 CLIA NUMBER - SIAMAK STEPHEN MARZBAN, MD INC

Laboratory Demographics

  • CLIA Code: 05D0553665
  • Facility Name: SIAMAK STEPHEN MARZBAN, MD INC
  • Facility Address: 2403 MORAY AVE STE 2A
    SAN PEDRO, CA
    ZIP 90732
  • Facility Phone: 310 832-2694
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SIAMAK S. MARZBAN
  • NPI Number: 1699076885
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0553665
LAB Type Physician Office
Facility Name SIAMAK STEPHEN MARZBAN, MD INC
Street 2403 MORAY AVE STE 2A
City SAN PEDRO
State CA
ZIP 90732
Phone 310 832-2694
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 SIAMAK S. MARZBAN

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