05D2098214 CLIA NUMBER - NILOO MEDICAL GROUP, INC

Laboratory Demographics

  • CLIA Code: 05D2098214
  • Facility Name: NILOO MEDICAL GROUP, INC
  • Facility Address: 4762 WHITTIER BLVD
    LOS ANGELES, CA
    ZIP 90022
  • Facility Phone: 323 796-0500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAYMOND MOALLEMI, MD
  • NPI Number: 1801214853
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2098214
LAB Type Physician Office
Facility Name NILOO MEDICAL GROUP, INC
Street 4762 WHITTIER BLVD
City LOS ANGELES
State CA
ZIP 90022
Phone 323 796-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2025
Certificate Expiration Date 1/22/2027
Facility Type Physician Office
Lab Director RAYMOND MOALLEMI, MD

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