05D2081249 CLIA NUMBER - WESTSIDE AESTHETICS

Laboratory Demographics

  • CLIA Code: 05D2081249
  • Facility Name: WESTSIDE AESTHETICS
  • Facility Address: 11645 WILSHIRE BLVD STE 800
    LOS ANGELES, CA
    ZIP 90025
  • Facility Phone: 310 443-5273
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEXANDER Z. RIVKIN, MD
  • NPI Number: 1396220752
  • Taxonomy: 103T00000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 05D2081249
LAB Type Physician Office
Facility Name WESTSIDE AESTHETICS
Street 11645 WILSHIRE BLVD STE 800
City LOS ANGELES
State CA
ZIP 90025
Phone 310 443-5273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Physician Office
Lab Director ALEXANDER Z. RIVKIN, MD

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