05D2076120 CLIA NUMBER - IMPERIAL RADIOLOGY

Laboratory Demographics

  • CLIA Code: 05D2076120
  • Facility Name: IMPERIAL RADIOLOGY
  • Facility Address: 2407 MARSHALL AVE STE A
    IMPERIAL, CA
    ZIP 92251
  • Facility Phone: 760 545-0340
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: AFSANEH MAGHSOUDY MD
  • NPI Number: 1912662883
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2076120
LAB Type Practitioner Other
Facility Name IMPERIAL RADIOLOGY
Street 2407 MARSHALL AVE STE A
City IMPERIAL
State CA
ZIP 92251
Phone 760 545-0340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Practitioner Other
Lab Director AFSANEH MAGHSOUDY MD

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