05D0684912 CLIA NUMBER - BENJAMIN BEHROOZAN MD

Laboratory Demographics

  • CLIA Code: 05D0684912
  • Facility Name: BENJAMIN BEHROOZAN MD
  • Facility Address: 2221 LINCOLN BLVD #200
    SANTA MONICA, CA
    ZIP 90405
  • Facility Phone: 310 396-9999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN BEHROOZAN
  • NPI Number: 1750440681
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0684912
LAB Type Physician Office
Facility Name BENJAMIN BEHROOZAN MD
Street 2221 LINCOLN BLVD #200
City SANTA MONICA
State CA
ZIP 90405
Phone 310 396-9999
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 BENJAMIN BEHROOZAN

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