05D2269047 CLIA NUMBER - BRYAN PEZESHKI MD INC

Laboratory Demographics

  • CLIA Code: 05D2269047
  • Facility Name: BRYAN PEZESHKI MD INC
  • Facility Address: 375 N LA CIENEGA BLVD UNIT 419
    WEST HOLLYWOOD, CA
    ZIP 90048
  • Facility Phone: 818 518-3240
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: BRYAN PEZESHKI
  • NPI Number: 1760912729
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2269047
LAB Type Mobile Laboratory
Facility Name BRYAN PEZESHKI MD INC
Street 375 N LA CIENEGA BLVD UNIT 419
City WEST HOLLYWOOD
State CA
ZIP 90048
Phone 818 518-3240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Mobile Laboratory
Lab Director BRYAN PEZESHKI

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