05D0948136 CLIA NUMBER - SELENA LANTRY MD, INC

Laboratory Demographics

  • CLIA Code: 05D0948136
  • Facility Name: SELENA LANTRY MD, INC
  • Facility Address: 1505 WILSON TERRACE, SUITE 130
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 247-2165
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SELENA A. LANTRY
  • NPI Number: 1063501880
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0948136
LAB Type Physician Office
Facility Name SELENA LANTRY MD, INC
Street 1505 WILSON TERRACE, SUITE 130
City GLENDALE
State CA
ZIP 91206
Phone 818 247-2165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director SELENA A. LANTRY

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