05D0968882 CLIA NUMBER - HRACH KHUDATYAN MD

Laboratory Demographics

  • CLIA Code: 05D0968882
  • Facility Name: HRACH KHUDATYAN MD
  • Facility Address: 134 N GLENDALE AVE
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 662-8858
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HRACH KHUDATYAN MD
  • NPI Number: 1720050032
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0968882
LAB Type Physician Office
Facility Name HRACH KHUDATYAN MD
Street 134 N GLENDALE AVE
City GLENDALE
State CA
ZIP 91206
Phone 818 662-8858
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2023
Certificate Expiration Date 12/26/2025
Facility Type Physician Office
Lab Director HRACH KHUDATYAN MD

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