05D2038532 CLIA NUMBER - SHARP IMAGING MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D2038532
  • Facility Name: SHARP IMAGING MEDICAL GROUP
  • Facility Address: 14600 SHERMAN WAY STE 100A
    VAN NUYS, CA
    ZIP 91405
  • Facility Phone: 818 815-3900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN N. BROURMAN
  • NPI Number: 1982909446
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2038532
LAB Type Physician Office
Facility Name SHARP IMAGING MEDICAL GROUP
Street 14600 SHERMAN WAY STE 100A
City VAN NUYS
State CA
ZIP 91405
Phone 818 815-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Physician Office
Lab Director STEVEN N. BROURMAN

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