05D0914671 CLIA NUMBER - KOOK I CHANG'S OFFICE

Laboratory Demographics

  • CLIA Code: 05D0914671
  • Facility Name: KOOK I CHANG'S OFFICE
  • Facility Address: 14600 SHERMAN WAY #270
    VAN NUYS, CA
    ZIP 91405
  • Facility Phone: 818 780-7771
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KOOK I. CHANG
  • NPI Number: 1356442354
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0914671
LAB Type Physician Office
Facility Name KOOK I CHANG'S OFFICE
Street 14600 SHERMAN WAY #270
City VAN NUYS
State CA
ZIP 91405
Phone 818 780-7771
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2024
Certificate Expiration Date 5/6/2026
Facility Type Physician Office
Lab Director KOOK I. CHANG

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