05D0870673 CLIA NUMBER - MAURICE GOURDJI, MD INC

Laboratory Demographics

  • CLIA Code: 05D0870673
  • Facility Name: MAURICE GOURDJI, MD INC
  • Facility Address: 5525 ETIWANDA AVE STE 110
    TARZANA, CA
    ZIP 91356
  • Facility Phone: 818 708-6070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAURICE GOURDJI MD
  • NPI Number: 1699751586
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0870673
LAB Type Physician Office
Facility Name MAURICE GOURDJI, MD INC
Street 5525 ETIWANDA AVE STE 110
City TARZANA
State CA
ZIP 91356
Phone 818 708-6070
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 MAURICE GOURDJI MD

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