05D2102189 CLIA NUMBER - VIRGIL ENDOSCOPY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2102189
  • Facility Name: VIRGIL ENDOSCOPY CENTER, LLC
  • Facility Address: 500 S VIRGIL AVE STE 301
    LOS ANGELES, CA
    ZIP 90020
  • Facility Phone: 213 738-6090
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PILSOO OH, MD
  • NPI Number: 1811447246
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2102189
LAB Type Ambulatory Surgery Center
Facility Name VIRGIL ENDOSCOPY CENTER, LLC
Street 500 S VIRGIL AVE STE 301
City LOS ANGELES
State CA
ZIP 90020
Phone 213 738-6090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Ambulatory Surgery Center
Lab Director PILSOO OH, MD

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