05D2320403 CLIA NUMBER - HILLCREST SURGERY CENTER INC

Laboratory Demographics

  • CLIA Code: 05D2320403
  • Facility Name: HILLCREST SURGERY CENTER INC
  • Facility Address: 640 S SAN VINCENTE BLVD #389
    LOS ANGELES, CA
    ZIP 90048
  • Facility Phone: 323 907-2992
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: IMAN RABIZADEH
  • NPI Number: 1982413514
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2320403
LAB Type Ambulatory Surgery Center
Facility Name HILLCREST SURGERY CENTER INC
Street 640 S SAN VINCENTE BLVD #389
City LOS ANGELES
State CA
ZIP 90048
Phone 323 907-2992
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Ambulatory Surgery Center
Lab Director IMAN RABIZADEH

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