05D2203501 CLIA NUMBER - VYTAL SURGICAL INSTITUTE

Laboratory Demographics

  • CLIA Code: 05D2203501
  • Facility Name: VYTAL SURGICAL INSTITUTE
  • Facility Address: 19228 VENTURA BLVD SUITE A
    TARZANA, CA
    ZIP 91356
  • Facility Phone: 818 578-5125
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. DAVID VAHEDI
  • NPI Number: 1619502283
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2203501
LAB Type Ambulatory Surgery Center
Facility Name VYTAL SURGICAL INSTITUTE
Street 19228 VENTURA BLVD SUITE A
City TARZANA
State CA
ZIP 91356
Phone 818 578-5125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. DAVID VAHEDI

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This page was last updated on: 3/20/2025