05D0935660 CLIA NUMBER - KERLAN-JOBE SURGERY CENTER, LLC DBA KERLAN-JOBE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D0935660
  • Facility Name: KERLAN-JOBE SURGERY CENTER, LLC DBA KERLAN-JOBE SURGERY CENTER
  • Facility Address: 6801 PARK TERRACE DRIVE, SUITE 300
    LOS ANGELES, CA
    ZIP 90045
  • Facility Phone: 310 665-7150
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. SHAWNA M. DORMAN
  • NPI Number: 1366408270
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0935660
LAB Type Ambulatory Surgery Center
Facility Name KERLAN-JOBE SURGERY CENTER, LLC DBA KERLAN-JOBE SURGERY CENTER
Street 6801 PARK TERRACE DRIVE, SUITE 300
City LOS ANGELES
State CA
ZIP 90045
Phone 310 665-7150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Ambulatory Surgery Center
Lab Director DR. SHAWNA M. DORMAN

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