05D2067946 CLIA NUMBER - BEVERLY CARDIOLOGY GROUP

Laboratory Demographics

  • CLIA Code: 05D2067946
  • Facility Name: BEVERLY CARDIOLOGY GROUP
  • Facility Address: 3919 BEVERLY BLVD STE 100
    LOS ANGELES, CA
    ZIP 90004
  • Facility Phone: 323 662-1175
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DIANA KIM
  • NPI Number: 1912331653
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2067946
LAB Type Physician Office
Facility Name BEVERLY CARDIOLOGY GROUP
Street 3919 BEVERLY BLVD STE 100
City LOS ANGELES
State CA
ZIP 90004
Phone 323 662-1175
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Physician Office
Lab Director DIANA KIM

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