05D0915790 CLIA NUMBER - BRENDA G BASS MD

Laboratory Demographics

  • CLIA Code: 05D0915790
  • Facility Name: BRENDA G BASS MD
  • Facility Address: 9201 SUNSET BLVD, #408
    LOS ANGELES, CA
    ZIP 90069
  • Facility Phone: 310 273-7401
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRENDA G. BASS
  • NPI Number: 1477627248
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0915790
LAB Type Physician Office
Facility Name BRENDA G BASS MD
Street 9201 SUNSET BLVD, #408
City LOS ANGELES
State CA
ZIP 90069
Phone 310 273-7401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Physician Office
Lab Director BRENDA G. BASS

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This page was last updated on: 3/20/2025