05D2164821 CLIA NUMBER - NUVATION PAIN GROUP

Laboratory Demographics

  • CLIA Code: 05D2164821
  • Facility Name: NUVATION PAIN GROUP
  • Facility Address: 505 S VIRGIL, SUITE 206
    LOS ANGELES, CA
    ZIP 90020
  • Facility Phone: 213 622-0021
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILLIP LIM
  • NPI Number: 1346616695
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2164821
LAB Type Physician Office
Facility Name NUVATION PAIN GROUP
Street 505 S VIRGIL, SUITE 206
City LOS ANGELES
State CA
ZIP 90020
Phone 213 622-0021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Physician Office
Lab Director PHILLIP LIM

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