05D2269125 CLIA NUMBER - SPRINTER MEDICAL WEST, PC

Laboratory Demographics

  • CLIA Code: 05D2269125
  • Facility Name: SPRINTER MEDICAL WEST, PC
  • Facility Address: 5230 PACIFIC CONCOURSE DR SUITE 102
    LOS ANGELES, CA
    ZIP 90045
  • Facility Phone: 415 432-7800
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: ARUN VILLIVALAM
  • NPI Number: 1790368702
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2269125
LAB Type Mobile Laboratory
Facility Name SPRINTER MEDICAL WEST, PC
Street 5230 PACIFIC CONCOURSE DR SUITE 102
City LOS ANGELES
State CA
ZIP 90045
Phone 415 432-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Mobile Laboratory
Lab Director ARUN VILLIVALAM

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