05D0972198 CLIA NUMBER - VICTOR M PEDROZA MD AMAVI A PROFESSIONAL MEDICAL CORP

Laboratory Demographics

  • CLIA Code: 05D0972198
  • Facility Name: VICTOR M PEDROZA MD AMAVI A PROFESSIONAL MEDICAL CORP
  • Facility Address: 2705 WHITTIER BLVD
    LOS ANGELES, CA
    ZIP 90023
  • Facility Phone: 323 263-3861
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICTOR M. PEDROZA MD
  • NPI Number: 1760527055
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0972198
LAB Type Physician Office
Facility Name VICTOR M PEDROZA MD AMAVI A PROFESSIONAL MEDICAL CORP
Street 2705 WHITTIER BLVD
City LOS ANGELES
State CA
ZIP 90023
Phone 323 263-3861
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 VICTOR M. PEDROZA MD

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