05D2107990 CLIA NUMBER - RAFFI TACHDJIAN, MD, INC A MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2107990
  • Facility Name: RAFFI TACHDJIAN, MD, INC A MEDICAL CORPORATION
  • Facility Address: 1301 20TH ST STE 380
    SANTA MONICA, CA
    ZIP 90404
  • Facility Phone: 310 998-0060
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAFFI TACHDJIAN
  • NPI Number: 1447376454
  • Taxonomy: 207K00000X - Allergy & Immunology

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CLIA Record

Field Name Field Value
CLIA Number 05D2107990
LAB Type Physician Office
Facility Name RAFFI TACHDJIAN, MD, INC A MEDICAL CORPORATION
Street 1301 20TH ST STE 380
City SANTA MONICA
State CA
ZIP 90404
Phone 310 998-0060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director RAFFI TACHDJIAN

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