05D1104153 CLIA NUMBER - CHRISTOPHER J CHARBONNET, MD

Laboratory Demographics

  • CLIA Code: 05D1104153
  • Facility Name: CHRISTOPHER J CHARBONNET, MD
  • Facility Address: 1530 E CHEVY CHASE DRIVE # 204
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 241-7246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER J. CHARBONNET, MD
  • NPI Number: 1225049968
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1104153
LAB Type Physician Office
Facility Name CHRISTOPHER J CHARBONNET, MD
Street 1530 E CHEVY CHASE DRIVE # 204
City GLENDALE
State CA
ZIP 91206
Phone 818 241-7246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Physician Office
Lab Director CHRISTOPHER J. CHARBONNET, MD

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