05D0914812 CLIA NUMBER - PRIMEX CLINICAL LABORATORIES, INC

Laboratory Demographics

  • CLIA Code: 05D0914812
  • Facility Name: PRIMEX CLINICAL LABORATORIES, INC
  • Facility Address: 16742 STAGG ST, STE 120
    VAN NUYS, CA
    ZIP 91406
  • Facility Phone: 818 779-0496
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: DAVID V. KON MD
  • NPI Number: 1043216682
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D0914812
LAB Type Independent
Facility Name PRIMEX CLINICAL LABORATORIES, INC
Street 16742 STAGG ST, STE 120
City VAN NUYS
State CA
ZIP 91406
Phone 818 779-0496
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/1/2022
Certificate Expiration Date 10/31/2025
Facility Type Independent
Lab Director DAVID V. KON MD

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