05D2084335 CLIA NUMBER - EVLYN AVANESSIAN MD INC

Laboratory Demographics

  • CLIA Code: 05D2084335
  • Facility Name: EVLYN AVANESSIAN MD INC
  • Facility Address: 3628 FOOTHILL BLVD
    GLENDALE, CA
    ZIP 91214
  • Facility Phone: 818 296-9601
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EVLYN AVANESSIAN MD
  • NPI Number: 1295020709
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2084335
LAB Type Physician Office
Facility Name EVLYN AVANESSIAN MD INC
Street 3628 FOOTHILL BLVD
City GLENDALE
State CA
ZIP 91214
Phone 818 296-9601
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Physician Office
Lab Director EVLYN AVANESSIAN MD

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