05D1009902 CLIA NUMBER - CHARLENE SONG MD

Laboratory Demographics

  • CLIA Code: 05D1009902
  • Facility Name: CHARLENE SONG MD
  • Facility Address: 520 S VIRGIL AVE STE 203
    LOS ANGELES, CA
    ZIP 90020
  • Facility Phone: 213 251-7897
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHARLENE SONG MD
  • NPI Number: 1316297476
  • Taxonomy: 171M00000X - Case Manager/Care Coordinator

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CLIA Record

Field Name Field Value
CLIA Number 05D1009902
LAB Type Physician Office
Facility Name CHARLENE SONG MD
Street 520 S VIRGIL AVE STE 203
City LOS ANGELES
State CA
ZIP 90020
Phone 213 251-7897
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 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director CHARLENE SONG MD

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