05D2315285 CLIA NUMBER - AGILE OCCUPATIONAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 05D2315285
  • Facility Name: AGILE OCCUPATIONAL MEDICINE, PC
  • Facility Address: 10630 SEPULVEDA BLVD STE 100
    MISSION HILLS, CA
    ZIP 91345
  • Facility Phone: 949 596-7145
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINH NGUYEN
  • NPI Number: 1073384624
  • Taxonomy: 261QX0100X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2315285
LAB Type Physician Office
Facility Name AGILE OCCUPATIONAL MEDICINE, PC
Street 10630 SEPULVEDA BLVD STE 100
City MISSION HILLS
State CA
ZIP 91345
Phone 949 596-7145
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Physician Office
Lab Director MINH NGUYEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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