05D0920520 CLIA NUMBER - KHACHATRIAN MED CORP

Laboratory Demographics

  • CLIA Code: 05D0920520
  • Facility Name: KHACHATRIAN MED CORP
  • Facility Address: 12643 SHERMAN WAY UNIT #1
    NORTH HOLLYWOOD, CA
    ZIP 91605
  • Facility Phone: 818 759-0095
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARINA KHACHATRIAN MD
  • NPI Number: 1225348006
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0920520
LAB Type Physician Office
Facility Name KHACHATRIAN MED CORP
Street 12643 SHERMAN WAY UNIT #1
City NORTH HOLLYWOOD
State CA
ZIP 91605
Phone 818 759-0095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Physician Office
Lab Director MARINA KHACHATRIAN MD

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