05D2153684 CLIA NUMBER - EDMUND H LEW MD INC

Laboratory Demographics

  • CLIA Code: 05D2153684
  • Facility Name: EDMUND H LEW MD INC
  • Facility Address: 1505 WILSON TERRACE STE 250
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 246-7115
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDMUND H. LEW
  • NPI Number: 1528027836
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2153684
LAB Type Physician Office
Facility Name EDMUND H LEW MD INC
Street 1505 WILSON TERRACE STE 250
City GLENDALE
State CA
ZIP 91206
Phone 818 246-7115
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Physician Office
Lab Director EDMUND H. LEW

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