05D1021969 CLIA NUMBER - MOEZ KHORSANDI DO INC

Laboratory Demographics

  • CLIA Code: 05D1021969
  • Facility Name: MOEZ KHORSANDI DO INC
  • Facility Address: 1245 WILSHIRE BLVD SUITE 408
    LOS ANGELES, CA
    ZIP 90017
  • Facility Phone: 213 482-2910
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MOEZ KHORSANDI DO
  • NPI Number: 1316987050
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 05D1021969
LAB Type Physician Office
Facility Name MOEZ KHORSANDI DO INC
Street 1245 WILSHIRE BLVD SUITE 408
City LOS ANGELES
State CA
ZIP 90017
Phone 213 482-2910
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 2/4/2024
Certificate Expiration Date 2/3/2026
Facility Type Physician Office
Lab Director MOEZ KHORSANDI DO

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