05D0699902 CLIA NUMBER - CENTURY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0699902
  • Facility Name: CENTURY MEDICAL GROUP
  • Facility Address: 15243 VANOWEN ST, STE 101
    VAN NUYS, CA
    ZIP 91405
  • Facility Phone: 818 785-0300
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DENISE A. PHAN
  • NPI Number: 1518081652
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0699902
LAB Type Physician Office
Facility Name CENTURY MEDICAL GROUP
Street 15243 VANOWEN ST, STE 101
City VAN NUYS
State CA
ZIP 91405
Phone 818 785-0300
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/27/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director DENISE A. PHAN

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