05D2023755 CLIA NUMBER - PACIFIC VASCUCARE, INC

Laboratory Demographics

  • CLIA Code: 05D2023755
  • Facility Name: PACIFIC VASCUCARE, INC
  • Facility Address: 1660 W THIRD ST
    LOS ANGELES, CA
    ZIP 90017
  • Facility Phone: 213 201-0850
  • Facility Type: Other - VASCULAR ACCESS CENTER
  • Facility Type: Waiver
  • Lab Director: EDWARD NEYMARK
  • NPI Number: 1578882965
  • Taxonomy: 2085R0204X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 05D2023755
LAB Type Other - VASCULAR ACCESS CENTER
Facility Name PACIFIC VASCUCARE, INC
Street 1660 W THIRD ST
City LOS ANGELES
State CA
ZIP 90017
Phone 213 201-0850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Other - VASCULAR ACCESS CENTER
Lab Director EDWARD NEYMARK

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