05D0976523 CLIA NUMBER - LILLY WILEN MD/A MEDICAL CORPORATION DBA NEW CONCEPTS MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0976523
  • Facility Name: LILLY WILEN MD/A MEDICAL CORPORATION DBA NEW CONCEPTS MEDICAL GROUP
  • Facility Address: 17075 DEVONSHIRE ST STE 306
    NORTHRIDGE, CA
    ZIP 91325
  • Facility Phone: 818 898-1447
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LILLY L. WILEN MD
  • NPI Number: 1275553679
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0976523
LAB Type Physician Office
Facility Name LILLY WILEN MD/A MEDICAL CORPORATION DBA NEW CONCEPTS MEDICAL GROUP
Street 17075 DEVONSHIRE ST STE 306
City NORTHRIDGE
State CA
ZIP 91325
Phone 818 898-1447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type Physician Office
Lab Director LILLY L. WILEN MD

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