05D2172564 CLIA NUMBER - DONGJIN SUNG, MD

Laboratory Demographics

  • CLIA Code: 05D2172564
  • Facility Name: DONGJIN SUNG, MD
  • Facility Address: 1740 W GARDENA BLVD
    GARDENA, CA
    ZIP 90247
  • Facility Phone: 424 551-3110
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONGJIN SUNG
  • NPI Number: 1114231198
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2172564
LAB Type Physician Office
Facility Name DONGJIN SUNG, MD
Street 1740 W GARDENA BLVD
City GARDENA
State CA
ZIP 90247
Phone 424 551-3110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2025
Certificate Expiration Date 9/24/2027
Facility Type Physician Office
Lab Director DONGJIN SUNG

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