05D0558455 CLIA NUMBER - MARVIN PIETRUSZKA MD DEL CARMEN MED CENTER

Laboratory Demographics

  • CLIA Code: 05D0558455
  • Facility Name: MARVIN PIETRUSZKA MD DEL CARMEN MED CENTER
  • Facility Address: 19234 VANOWEN STREET
    RESEDA, CA
    ZIP 91335
  • Facility Phone: 818 705-1157
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MARVIN PIETRUSZKA
  • NPI Number: 1740393446
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0558455
LAB Type Independent
Facility Name MARVIN PIETRUSZKA MD DEL CARMEN MED CENTER
Street 19234 VANOWEN STREET
City RESEDA
State CA
ZIP 91335
Phone 818 705-1157
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 Independent
Lab Director MARVIN PIETRUSZKA

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