05D2078695 CLIA NUMBER - VIP URGENT CARE

Laboratory Demographics

  • CLIA Code: 05D2078695
  • Facility Name: VIP URGENT CARE
  • Facility Address: 18751 VENTURA BLVD
    TARZANA, CA
    ZIP 91356
  • Facility Phone: 818 600-4144
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JAIME A. DIAZ, MD
  • NPI Number: 1770910986
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2078695
LAB Type Comp. Outpatient Rehab Facility
Facility Name VIP URGENT CARE
Street 18751 VENTURA BLVD
City TARZANA
State CA
ZIP 91356
Phone 818 600-4144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director JAIME A. DIAZ, MD

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