05D2038926 CLIA NUMBER - JACKLIN POLADIAN MD INC

Laboratory Demographics

  • CLIA Code: 05D2038926
  • Facility Name: JACKLIN POLADIAN MD INC
  • Facility Address: 800 S FAIRMOUNT AVE STE 420
    PASADENA, CA
    ZIP 91105
  • Facility Phone: 626 200-4500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACKLIN POLADIAN
  • NPI Number: 1629239892
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2038926
LAB Type Physician Office
Facility Name JACKLIN POLADIAN MD INC
Street 800 S FAIRMOUNT AVE STE 420
City PASADENA
State CA
ZIP 91105
Phone 626 200-4500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Physician Office
Lab Director JACKLIN POLADIAN

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