05D1077010 CLIA NUMBER - PROFILES SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1077010
  • Facility Name: PROFILES SURGERY CENTER
  • Facility Address: 9201 W SUNSET BLVD M130
    WEST HOLLYWOOD, CA
    ZIP 90069
  • Facility Phone: 310 276-6800
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PEYMAN SOLIEMANZADEH MD
  • NPI Number: 1609188481
  • Taxonomy: 207YS0123X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 05D1077010
LAB Type Ambulatory Surgery Center
Facility Name PROFILES SURGERY CENTER
Street 9201 W SUNSET BLVD M130
City WEST HOLLYWOOD
State CA
ZIP 90069
Phone 310 276-6800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Ambulatory Surgery Center
Lab Director PEYMAN SOLIEMANZADEH MD

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