05D2190149 CLIA NUMBER - AMIN KHORSANDI MD INC

Laboratory Demographics

  • CLIA Code: 05D2190149
  • Facility Name: AMIN KHORSANDI MD INC
  • Facility Address: 2222 SANTA MONICA BLVS SUITE 301
    SANTA MONICA, CA
    ZIP 90404
  • Facility Phone: 310 449-0093
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMIN KHORSANDI
  • NPI Number: 1275547390
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2190149
LAB Type Physician Office
Facility Name AMIN KHORSANDI MD INC
Street 2222 SANTA MONICA BLVS SUITE 301
City SANTA MONICA
State CA
ZIP 90404
Phone 310 449-0093
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Physician Office
Lab Director AMIN KHORSANDI

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