05D0872707 CLIA NUMBER - CENTRO MEDICO FAMILIAR

Laboratory Demographics

  • CLIA Code: 05D0872707
  • Facility Name: CENTRO MEDICO FAMILIAR
  • Facility Address: 14547 VICTORY BLVD
    VAN NUYS, CA
    ZIP 91411
  • Facility Phone: 818 997-3232
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHER RAM
  • NPI Number: 1497951370
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0872707
LAB Type Physician Office
Facility Name CENTRO MEDICO FAMILIAR
Street 14547 VICTORY BLVD
City VAN NUYS
State CA
ZIP 91411
Phone 818 997-3232
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Physician Office
Lab Director ASHER RAM

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