05D0982955 CLIA NUMBER - MI-JEONG LEE MD

Laboratory Demographics

  • CLIA Code: 05D0982955
  • Facility Name: MI-JEONG LEE MD
  • Facility Address: 2675 W OLYMPIC BLVD STE 103
    LOS ANGELES, CA
    ZIP 90006
  • Facility Phone: 213 252-0036
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MI JEONG LEE MD
  • NPI Number: 1568481471
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0982955
LAB Type Physician Office
Facility Name MI-JEONG LEE MD
Street 2675 W OLYMPIC BLVD STE 103
City LOS ANGELES
State CA
ZIP 90006
Phone 213 252-0036
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Physician Office
Lab Director MI JEONG LEE MD

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