05D1099886 CLIA NUMBER - LIBBIT SURGICAL CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D1099886
  • Facility Name: LIBBIT SURGICAL CENTER, LLC
  • Facility Address: 16260 VENTURA BLVD STE 309
    ENCINO, CA
    ZIP 91436
  • Facility Phone: 818 788-4341
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Microscopy
  • Lab Director: ILYA M. RACHMAN, MD
  • NPI Number: 1518106582
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1099886
LAB Type Ambulatory Surgery Center
Facility Name LIBBIT SURGICAL CENTER, LLC
Street 16260 VENTURA BLVD STE 309
City ENCINO
State CA
ZIP 91436
Phone 818 788-4341
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Ambulatory Surgery Center
Lab Director ILYA M. RACHMAN, MD

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