05D2301598 CLIA NUMBER - RICHARD PARK MD A PROFESSIONAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2301598
  • Facility Name: RICHARD PARK MD A PROFESSIONAL CORPORATION
  • Facility Address: 10515 BALBOA BLVD STE 325
    GRANADA HILLS, CA
    ZIP 91344
  • Facility Phone: 818 678-9875
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD PARK
  • NPI Number: 1982946323
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2301598
LAB Type Physician Office
Facility Name RICHARD PARK MD A PROFESSIONAL CORPORATION
Street 10515 BALBOA BLVD STE 325
City GRANADA HILLS
State CA
ZIP 91344
Phone 818 678-9875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Physician Office
Lab Director RICHARD PARK

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