05D1001720 CLIA NUMBER - SAMUEL K LEE MD INC

Laboratory Demographics

  • CLIA Code: 05D1001720
  • Facility Name: SAMUEL K LEE MD INC
  • Facility Address: 266 S HARVARD BLVD STE 366
    LOS ANGELES, CA
    ZIP 90004
  • Facility Phone: 213 413-2622
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAMUEL K. LEE MD
  • NPI Number: 1922023043
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 05D1001720
LAB Type Physician Office
Facility Name SAMUEL K LEE MD INC
Street 266 S HARVARD BLVD STE 366
City LOS ANGELES
State CA
ZIP 90004
Phone 213 413-2622
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Physician Office
Lab Director SAMUEL K. LEE MD

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