05D0943646 CLIA NUMBER - SHAVASH SAFVATI MD

Laboratory Demographics

  • CLIA Code: 05D0943646
  • Facility Name: SHAVASH SAFVATI MD
  • Facility Address: 12626 RIVERSIDE DRIVE,SUITE 303
    N HOLLYWOOD, CA
    ZIP 91607
  • Facility Phone: 818 760-2434
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAVASH SAFVATI
  • NPI Number: 1083704076
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0943646
LAB Type Physician Office
Facility Name SHAVASH SAFVATI MD
Street 12626 RIVERSIDE DRIVE,SUITE 303
City N HOLLYWOOD
State CA
ZIP 91607
Phone 818 760-2434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2024
Certificate Expiration Date 3/30/2026
Facility Type Physician Office
Lab Director SHAVASH SAFVATI

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