05D2009104 CLIA NUMBER - BORIS VAISMAN MEDICAL CORP.

Laboratory Demographics

  • CLIA Code: 05D2009104
  • Facility Name: BORIS VAISMAN MEDICAL CORP.
  • Facility Address: 22600 VENTURA BLVD, UNIT 101
    WOODLAND HILLS, CA
    ZIP 91364
  • Facility Phone: 818 225-1255
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BORIS VAISMAN
  • NPI Number: 1508801994
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D2009104
LAB Type Physician Office
Facility Name BORIS VAISMAN MEDICAL CORP.
Street 22600 VENTURA BLVD, UNIT 101
City WOODLAND HILLS
State CA
ZIP 91364
Phone 818 225-1255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Physician Office
Lab Director BORIS VAISMAN

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