05D1077012 CLIA NUMBER - MARTIN N GORDON MD

Laboratory Demographics

  • CLIA Code: 05D1077012
  • Facility Name: MARTIN N GORDON MD
  • Facility Address: 9401 WILSHIRE BLVD #515
    BEVERLY HILLS, CA
    ZIP 90212
  • Facility Phone: 310 432-4260
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARTIN N. GORDON MD
  • NPI Number: 1447353313
  • Taxonomy: 207RP1001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1077012
LAB Type Physician Office
Facility Name MARTIN N GORDON MD
Street 9401 WILSHIRE BLVD #515
City BEVERLY HILLS
State CA
ZIP 90212
Phone 310 432-4260
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 Physician Office
Lab Director MARTIN N. GORDON MD

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