05D1063080 CLIA NUMBER - SAMAN GHALILI MD

Laboratory Demographics

  • CLIA Code: 05D1063080
  • Facility Name: SAMAN GHALILI MD
  • Facility Address: 2101 SAN PEDRO STREET
    LOS ANGELES, CA
    ZIP 90011
  • Facility Phone: 213 745-8766
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMAN GHALILI
  • NPI Number: 1366735813
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D1063080
LAB Type Physician Office
Facility Name SAMAN GHALILI MD
Street 2101 SAN PEDRO STREET
City LOS ANGELES
State CA
ZIP 90011
Phone 213 745-8766
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Physician Office
Lab Director SAMAN GHALILI

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