05D1063626 CLIA NUMBER - KENNETH K KIM, A MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D1063626
  • Facility Name: KENNETH K KIM, A MEDICAL CORPORATION
  • Facility Address: 520 S VIRGIL AVE STE 106
    LOS ANGELES, CA
    ZIP 90020
  • Facility Phone: 213 234-5575
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH K. KIM MD
  • NPI Number: 1295776474
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1063626
LAB Type Physician Office
Facility Name KENNETH K KIM, A MEDICAL CORPORATION
Street 520 S VIRGIL AVE STE 106
City LOS ANGELES
State CA
ZIP 90020
Phone 213 234-5575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Physician Office
Lab Director KENNETH K. KIM MD

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