05D1032697 CLIA NUMBER - LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GRP INC

Laboratory Demographics

  • CLIA Code: 05D1032697
  • Facility Name: LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GRP INC
  • Facility Address: 191 S BUENA VISTA ST, STE 150
    BURBANK, CA
    ZIP 91505
  • Facility Phone: 818 295-5920
  • Facility Type: Other - URGENT CARE FACILITY
  • Facility Type: Certificate of Compliance
  • Lab Director: DANNY ZAGHI
  • NPI Number: 1689874596
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1032697
LAB Type Other - URGENT CARE FACILITY
Facility Name LAKESIDE MEDICAL ORGANIZATION, A MEDICAL GRP INC
Street 191 S BUENA VISTA ST, STE 150
City BURBANK
State CA
ZIP 91505
Phone 818 295-5920
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/19/2023
Certificate Expiration Date 8/18/2025
Facility Type Other - URGENT CARE FACILITY
Lab Director DANNY ZAGHI

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This page was last updated on: 6/4/2025