05D0557721 CLIA NUMBER - BRIAN FENMORE MD

Laboratory Demographics

  • CLIA Code: 05D0557721
  • Facility Name: BRIAN FENMORE MD
  • Facility Address: 18344 CLARK STREET #202
    TARZANA, CA
    ZIP 91356
  • Facility Phone: 818 708-8011
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN K. FENMORE
  • NPI Number: 1215107792
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0557721
LAB Type Physician Office
Facility Name BRIAN FENMORE MD
Street 18344 CLARK STREET #202
City TARZANA
State CA
ZIP 91356
Phone 818 708-8011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2024
Certificate Expiration Date 12/27/2026
Facility Type Physician Office
Lab Director BRIAN K. FENMORE

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