05D2119262 CLIA NUMBER - KIDS AND TEENS MEDICAL GROUP JANESRI DE SILVA, MD

Laboratory Demographics

  • CLIA Code: 05D2119262
  • Facility Name: KIDS AND TEENS MEDICAL GROUP JANESRI DE SILVA, MD
  • Facility Address: 1021 FOOTHILL BLVD
    LA CANADA FLINTRIDGE, CA
    ZIP 91011
  • Facility Phone: 818 361-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JANESRI DE SILVA
  • NPI Number: 1326278490
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2119262
LAB Type Physician Office
Facility Name KIDS AND TEENS MEDICAL GROUP JANESRI DE SILVA, MD
Street 1021 FOOTHILL BLVD
City LA CANADA FLINTRIDGE
State CA
ZIP 91011
Phone 818 361-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Physician Office
Lab Director JANESRI DE SILVA

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