05D2109095 CLIA NUMBER - PEJMAN SAMOUHA, MD INC

Laboratory Demographics

  • CLIA Code: 05D2109095
  • Facility Name: PEJMAN SAMOUHA, MD INC
  • Facility Address: 1435 S VERMONT AVE STE 100
    LOS ANGELES, CA
    ZIP 90006
  • Facility Phone: 213 386-2511
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PEJMAN SAMOUHA, MD
  • NPI Number: 1437397205
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D2109095
LAB Type Physician Office
Facility Name PEJMAN SAMOUHA, MD INC
Street 1435 S VERMONT AVE STE 100
City LOS ANGELES
State CA
ZIP 90006
Phone 213 386-2511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Physician Office
Lab Director PEJMAN SAMOUHA, MD

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