05D1025805 CLIA NUMBER - MAGED BASILIOS, MD INC

Laboratory Demographics

  • CLIA Code: 05D1025805
  • Facility Name: MAGED BASILIOS, MD INC
  • Facility Address: 4505 E SLAUSON AVE STE E
    MAYWOOD, CA
    ZIP 90270
  • Facility Phone: 323 771-0080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAGED Z. BASILIOS MD
  • NPI Number: 1225021462
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1025805
LAB Type Physician Office
Facility Name MAGED BASILIOS, MD INC
Street 4505 E SLAUSON AVE STE E
City MAYWOOD
State CA
ZIP 90270
Phone 323 771-0080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type Physician Office
Lab Director MAGED Z. BASILIOS MD

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