05D0595200 CLIA NUMBER - IRINA KHIDEKEL, MD PROFESSIONAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D0595200
  • Facility Name: IRINA KHIDEKEL, MD PROFESSIONAL CORPORATION
  • Facility Address: 3635 CALIFORNIA ST
    SAN FRANCISCO, CA
    ZIP 94118
  • Facility Phone: 415 752-0277
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IRINA KHIDEKEL
  • NPI Number: 1205928348
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0595200
LAB Type Physician Office
Facility Name IRINA KHIDEKEL, MD PROFESSIONAL CORPORATION
Street 3635 CALIFORNIA ST
City SAN FRANCISCO
State CA
ZIP 94118
Phone 415 752-0277
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2024
Certificate Expiration Date 4/18/2026
Facility Type Physician Office
Lab Director IRINA KHIDEKEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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