05D2106290 CLIA NUMBER - DOHENY EYE CENTER UCLA

Laboratory Demographics

CLIA Number: 05D2106290

Facility Name: DOHENY EYE CENTER UCLA

Facility Address:
625 S FAIR OAKS AVE STE 280
PASADENA, CA
ZIP 91105
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Facility Phone Number: 626 817-4747

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1346695863

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	05D2106290
LAB Type	Physician Office
Facility Name	DOHENY EYE CENTER UCLA
Street	625 S FAIR OAKS AVE STE 280
City	PASADENA
State	CA
ZIP	91105
Phone	626 817-4747
CertificateType	4
CertificateEffectiveDate	6/21/2023
CertificateExpirationDate	6/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024