05D2308399 CLIA NUMBER - EPICWAVE LABORATORY

Laboratory Demographics

  • CLIA Code: 05D2308399
  • Facility Name: EPICWAVE LABORATORY
  • Facility Address: 16114 SHERMAN WAY
    VAN NUYS, CA
    ZIP 91406
  • Facility Phone: 818 687-6653
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. MIR H. NOORBAKHSH
  • NPI Number: 1023765385
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D2308399
LAB Type Physician Office
Facility Name EPICWAVE LABORATORY
Street 16114 SHERMAN WAY
City VAN NUYS
State CA
ZIP 91406
Phone 818 687-6653
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/31/2024
Certificate Expiration Date 12/30/2026
Facility Type Physician Office
Lab Director DR. MIR H. NOORBAKHSH

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