05D2169648 CLIA NUMBER - VICTOR GONZALEZ CARABELLO MD

Laboratory Demographics

  • CLIA Code: 05D2169648
  • Facility Name: VICTOR GONZALEZ CARABELLO MD
  • Facility Address: 605 N MEDNIK AVE
    EAST LOS ANGELES, CA
    ZIP 90022
  • Facility Phone: 323 526-2880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARABELLO GONZALEZ
  • NPI Number: 1710070099
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2169648
LAB Type Physician Office
Facility Name VICTOR GONZALEZ CARABELLO MD
Street 605 N MEDNIK AVE
City EAST LOS ANGELES
State CA
ZIP 90022
Phone 323 526-2880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director CARABELLO GONZALEZ

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