05D0911032 CLIA NUMBER - HERACH YADEGARIAN, MD A MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D0911032
  • Facility Name: HERACH YADEGARIAN, MD A MEDICAL CORPORATION
  • Facility Address: 411 N CENTRAL AVE STE 130
    GLENDALE, CA
    ZIP 91203
  • Facility Phone: 818 240-8767
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HERACH H. YADEGARIAN
  • NPI Number: 1124188628
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0911032
LAB Type Physician Office
Facility Name HERACH YADEGARIAN, MD A MEDICAL CORPORATION
Street 411 N CENTRAL AVE STE 130
City GLENDALE
State CA
ZIP 91203
Phone 818 240-8767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Physician Office
Lab Director HERACH H. YADEGARIAN

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