05D2051042 CLIA NUMBER - MIRACLE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2051042
  • Facility Name: MIRACLE SURGERY CENTER
  • Facility Address: 2080 CENTURY PARK EAST, STE. 606
    LOS ANGELES, CA
    ZIP 90067
  • Facility Phone: 310 274-4900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: FAZIN KERENDIAN
  • NPI Number: 1689324758
  • Taxonomy: 208200000X - Plastic Surgery

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2051042
LAB Type Ambulatory Surgery Center
Facility Name MIRACLE SURGERY CENTER
Street 2080 CENTURY PARK EAST, STE. 606
City LOS ANGELES
State CA
ZIP 90067
Phone 310 274-4900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Ambulatory Surgery Center
Lab Director FAZIN KERENDIAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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