05D2047630 CLIA NUMBER - ADVENTIST HEALTH PHYSICIANS NETWORK FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 05D2047630
  • Facility Name: ADVENTIST HEALTH PHYSICIANS NETWORK FAMILY MEDICINE
  • Facility Address: 1560 E CHEVY CHASE DR SUITE 245
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 246-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DMITRY GEN
  • NPI Number: 1083976294
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2047630
LAB Type Physician Office
Facility Name ADVENTIST HEALTH PHYSICIANS NETWORK FAMILY MEDICINE
Street 1560 E CHEVY CHASE DR SUITE 245
City GLENDALE
State CA
ZIP 91206
Phone 818 246-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Physician Office
Lab Director DMITRY GEN

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