05D1047844 CLIA NUMBER - AZHAR MUTTALIB, MD

Laboratory Demographics

  • CLIA Code: 05D1047844
  • Facility Name: AZHAR MUTTALIB, MD
  • Facility Address: 23639 HAWTHORNE BLVD STE 102
    TORRANCE, CA
    ZIP 90505
  • Facility Phone: 310 373-9980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AZHAR MUTTALIB, MD
  • NPI Number: 1124054721
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1047844
LAB Type Physician Office
Facility Name AZHAR MUTTALIB, MD
Street 23639 HAWTHORNE BLVD STE 102
City TORRANCE
State CA
ZIP 90505
Phone 310 373-9980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Physician Office
Lab Director AZHAR MUTTALIB, MD

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