05D0868792 CLIA NUMBER - REZA BONABI MD INC

Laboratory Demographics

CLIA Number: 05D0868792

Facility Name: REZA BONABI MD INC

Facility Address:
17075 DEVONSHIRE STREET SUITE 301
NORTHRIDGE, CA
ZIP 91325
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Facility Phone Number: (818) 368-4212

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1366607988

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0868792
LAB Type	PHYSICIAN OFFICE
Facility Name	REZA BONABI MD INC
Street	17075 DEVONSHIRE STREET SUITE 301
City	NORTHRIDGE
State	CA
ZIP	91325
Phone	(818) 368-4212

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This page was last updated on: 5/11/2023