05D1013792 CLIA NUMBER - MARK SONG MD PHD INC

Laboratory Demographics

  • CLIA Code: 05D1013792
  • Facility Name: MARK SONG MD PHD INC
  • Facility Address: 3663 W 6TH ST STE 307
    LOS ANGELES, CA
    ZIP 90020
  • Facility Phone: 213 736-1884
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK SONG MD
  • NPI Number: 1326068560
  • Taxonomy: 207RN0300X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1013792
LAB Type Physician Office
Facility Name MARK SONG MD PHD INC
Street 3663 W 6TH ST STE 307
City LOS ANGELES
State CA
ZIP 90020
Phone 213 736-1884
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 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Physician Office
Lab Director MARK SONG MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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