05D0959570 CLIA NUMBER - DAVID S KIM OB GYN MEDICAL GROUP CORPORATION

Laboratory Demographics

CLIA Number: 05D0959570

Facility Name: DAVID S KIM OB GYN MEDICAL GROUP CORPORATION

Facility Address:
500 S VIRGIL AVE STE 201
LOS ANGELES, CA
ZIP 90020
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Facility Phone Number: 213 980-5975

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407099492

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	05D0959570
LAB Type	Physician Office
Facility Name	DAVID S KIM OB GYN MEDICAL GROUP CORPORATION
Street	500 S VIRGIL AVE STE 201
City	LOS ANGELES
State	CA
ZIP	90020
Phone	213 980-5975
CertificateType	4
CertificateEffectiveDate	2/2/2024
CertificateExpirationDate	2/1/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024