05D0926517 CLIA NUMBER - KIDS AND TEENS MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0926517
  • Facility Name: KIDS AND TEENS MEDICAL GROUP
  • Facility Address: 3831 HUGHES AVE, SUITE 602
    CULVER CITY, CA
    ZIP 90232
  • Facility Phone: 818 361-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JANESRI DE SILVA
  • NPI Number: 1972523728
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0926517
LAB Type Physician Office
Facility Name KIDS AND TEENS MEDICAL GROUP
Street 3831 HUGHES AVE, SUITE 602
City CULVER CITY
State CA
ZIP 90232
Phone 818 361-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Physician Office
Lab Director DR. JANESRI DE SILVA

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