05D2136285 CLIA NUMBER - KIAVASH NIKKHOU M.D.

Laboratory Demographics

CLIA Number: 05D2136285

Facility Name: KIAVASH NIKKHOU M.D.

Facility Address:
415 ROLLING OAKS DR STE 260
THOUSAND OAKS, CA
ZIP 91361
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Facility Phone Number: 805 309-2555

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1588198790

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	05D2136285
LAB Type	Physician Office
Facility Name	KIAVASH NIKKHOU M.D.
Street	415 ROLLING OAKS DR STE 260
City	THOUSAND OAKS
State	CA
ZIP	91361
Phone	805 309-2555
CertificateType	4
CertificateEffectiveDate	9/6/2023
CertificateExpirationDate	9/5/2025
FacilityType	Waiver

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