05D1027418 CLIA NUMBER - CHEVY CHASE AMBULATORY CENTER

Laboratory Demographics

  • CLIA Code: 05D1027418
  • Facility Name: CHEVY CHASE AMBULATORY CENTER
  • Facility Address: 801 S CHEVY CHASE DR #106
    GLENDALE, CA
    ZIP 91205
  • Facility Phone: 818 265-2275
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. PAYAM AMINI
  • NPI Number: 1497733661
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1027418
LAB Type Ambulatory Surgery Center
Facility Name CHEVY CHASE AMBULATORY CENTER
Street 801 S CHEVY CHASE DR #106
City GLENDALE
State CA
ZIP 91205
Phone 818 265-2275
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2023
Certificate Expiration Date 12/10/2025
Facility Type Ambulatory Surgery Center
Lab Director DR. PAYAM AMINI

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This page was last updated on: 3/20/2025