05D1014332 CLIA NUMBER - ANTAKI AND ASSOCIATES INFECTIOUS DISEASE MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D1014332

Facility Name: ANTAKI AND ASSOCIATES INFECTIOUS DISEASE MEDICAL GROUP INC

Facility Address:
801 S CHEVY CHASE DRIVE SUITE 105
GLENDALE, CA
ZIP 91205
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Facility Phone Number: 818 242-5299

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124083274

Taxonomy: 207RI0200X - Internal Medicine
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

CLIA Record

Field Name	Field Value
CLIA Number	05D1014332
LAB Type	Physician Office
Facility Name	ANTAKI AND ASSOCIATES INFECTIOUS DISEASE MEDICAL GROUP INC
Street	801 S CHEVY CHASE DRIVE SUITE 105
City	GLENDALE
State	CA
ZIP	91205
Phone	818 242-5299
CertificateType	4
CertificateEffectiveDate	7/2/2023
CertificateExpirationDate	7/1/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024