05D0865769 CLIA NUMBER - VIJAY M DHAWAN MD INC

Laboratory Demographics

  • CLIA Code: 05D0865769
  • Facility Name: VIJAY M DHAWAN MD INC
  • Facility Address: 3420 WEST BEVERLY BOULEVARD
    MONTEBELLO, CA
    ZIP 90640
  • Facility Phone: 323 721-9411
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIJAY M. DHAWAN
  • NPI Number: 1760426415
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0865769
LAB Type Physician Office
Facility Name VIJAY M DHAWAN MD INC
Street 3420 WEST BEVERLY BOULEVARD
City MONTEBELLO
State CA
ZIP 90640
Phone 323 721-9411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Physician Office
Lab Director VIJAY M. DHAWAN

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