05D0973916 CLIA NUMBER - IMD MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0973916
  • Facility Name: IMD MEDICAL GROUP INC
  • Facility Address: 1234 N VERMONT AVE
    LOS ANGELES, CA
    ZIP 90029
  • Facility Phone: 323 660-5624
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IMAD EL ASMAR MD
  • NPI Number: 1508804006
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0973916
LAB Type Physician Office
Facility Name IMD MEDICAL GROUP INC
Street 1234 N VERMONT AVE
City LOS ANGELES
State CA
ZIP 90029
Phone 323 660-5624
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Physician Office
Lab Director IMAD EL ASMAR MD

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