05D0985323 CLIA NUMBER - SUNRISE-WESTSIDE - ADHC

Laboratory Demographics

  • CLIA Code: 05D0985323
  • Facility Name: SUNRISE-WESTSIDE - ADHC
  • Facility Address: 7014 W SUNSET BLVD
    LOS ANGELES, CA
    ZIP 90028
  • Facility Phone: 323 463-0500
  • Facility Type: Other - ADHC/CBAS
  • Facility Type: Waiver
  • Lab Director: IGOR GOROKHOV
  • NPI Number: 1770705105
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0985323
LAB Type Other - ADHC/CBAS
Facility Name SUNRISE-WESTSIDE - ADHC
Street 7014 W SUNSET BLVD
City LOS ANGELES
State CA
ZIP 90028
Phone 323 463-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Other - ADHC/CBAS
Lab Director IGOR GOROKHOV

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