05D0953999 CLIA NUMBER - FRED KYAZZE, MD INC DBA GALA CARE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D0953999
  • Facility Name: FRED KYAZZE, MD INC DBA GALA CARE MEDICAL CLINIC
  • Facility Address: 1410 W ALONDRA BLVD SUITE C
    COMPTON, CA
    ZIP 90220
  • Facility Phone: 310 637-3680
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRED B. KYAZZE MD
  • NPI Number: 1033110861
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0953999
LAB Type Physician Office
Facility Name FRED KYAZZE, MD INC DBA GALA CARE MEDICAL CLINIC
Street 1410 W ALONDRA BLVD SUITE C
City COMPTON
State CA
ZIP 90220
Phone 310 637-3680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Physician Office
Lab Director FRED B. KYAZZE MD

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