05D2159595 CLIA NUMBER - LEO POLOSAJIAN,MD

Laboratory Demographics

  • CLIA Code: 05D2159595
  • Facility Name: LEO POLOSAJIAN,MD
  • Facility Address: 7640 TAMPA AVE SUITE 101
    RESEDA, CA
    ZIP 91335
  • Facility Phone: 818 718-1600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LEO POLOSAJIAN
  • NPI Number: 1174664783
  • Taxonomy: 207RC0001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2159595
LAB Type Physician Office
Facility Name LEO POLOSAJIAN,MD
Street 7640 TAMPA AVE SUITE 101
City RESEDA
State CA
ZIP 91335
Phone 818 718-1600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Physician Office
Lab Director LEO POLOSAJIAN

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