05D2246807 CLIA NUMBER - AVY, LLC

Laboratory Demographics

  • CLIA Code: 05D2246807
  • Facility Name: AVY, LLC
  • Facility Address: 1510 S CENTRAL AVENUE, SUITE #140
    GLENDALE, CA
    ZIP 91204
  • Facility Phone: 310 467-5197
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: HOOMAN KASHANI
  • NPI Number: 1649855297
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2246807
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name AVY, LLC
Street 1510 S CENTRAL AVENUE, SUITE #140
City GLENDALE
State CA
ZIP 91204
Phone 310 467-5197
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director HOOMAN KASHANI

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