05D2309337 CLIA NUMBER - PRIME URGENT CARE

Laboratory Demographics

  • CLIA Code: 05D2309337
  • Facility Name: PRIME URGENT CARE
  • Facility Address: 17609 VENTURA BLVD # 106
    ENCINO, CA
    ZIP 91316
  • Facility Phone: 818 774-2757
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SHARAM SALIMITARI
  • NPI Number: 1659138444
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2309337
LAB Type Practitioner Other
Facility Name PRIME URGENT CARE
Street 17609 VENTURA BLVD # 106
City ENCINO
State CA
ZIP 91316
Phone 818 774-2757
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Practitioner Other
Lab Director SHARAM SALIMITARI

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