05D0921038 CLIA NUMBER - MISSAK KLTCHIAN MD

Laboratory Demographics

  • CLIA Code: 05D0921038
  • Facility Name: MISSAK KLTCHIAN MD
  • Facility Address: 4645 HOLLYWOOD BOULEVARD SUITE #4
    LOS ANGELES, CA
    ZIP 90027
  • Facility Phone: 213 661-4500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MISSAK KLTCHIAN MD
  • NPI Number: 1932695079
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0921038
LAB Type Physician Office
Facility Name MISSAK KLTCHIAN MD
Street 4645 HOLLYWOOD BOULEVARD SUITE #4
City LOS ANGELES
State CA
ZIP 90027
Phone 213 661-4500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Physician Office
Lab Director MISSAK KLTCHIAN MD

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