05D0926362 CLIA NUMBER - PLAZA MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D0926362
  • Facility Name: PLAZA MEDICAL CLINIC
  • Facility Address: 7020 VAN NUYS BOULEVARD
    VAN NUYS, CA
    ZIP 91405
  • Facility Phone: 818 780-7900
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOHN P. YERMIAN
  • NPI Number: 1912227257
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0926362
LAB Type Practitioner Other
Facility Name PLAZA MEDICAL CLINIC
Street 7020 VAN NUYS BOULEVARD
City VAN NUYS
State CA
ZIP 91405
Phone 818 780-7900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Practitioner Other
Lab Director JOHN P. YERMIAN

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