05D0893428 CLIA NUMBER - MEDARDO SUPNET MD INC

Laboratory Demographics

  • CLIA Code: 05D0893428
  • Facility Name: MEDARDO SUPNET MD INC
  • Facility Address: 3585 E IMPERIAL HWY
    LYNWOOD, CA
    ZIP 90262
  • Facility Phone: 310 605-4260
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MEDARDO C. SUPNET MD
  • NPI Number: 1003089970
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0893428
LAB Type Physician Office
Facility Name MEDARDO SUPNET MD INC
Street 3585 E IMPERIAL HWY
City LYNWOOD
State CA
ZIP 90262
Phone 310 605-4260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Physician Office
Lab Director MEDARDO C. SUPNET MD

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