CLIA lab
CLIA 05D2172564: Dongjin Sung, MD
Gardena, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2172564 belongs to Dongjin Sung, MD in Gardena, CA.
Certificate of Waiver, effective September 25, 2025, expires September 24, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 25, 2025
- Certificate expiration
- September 24, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 25, 2019
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D2172564
- Lab name
- Dongjin Sung, MD
- Address
- 1740 W Gardena Blvd, Gardena, CA 90247
- Phone
- (424) 551-3110
- Fax
- (844) 272-8062
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Adel S Metry MDCertificate of Waiver, Physician office05D1009593
- Anjanette Hogan MD IncCertificate for Provider-Performed Microscopy Procedures, Physician office05D1061260
- Annette A Coronel-Perey, MD IncCertificate of Waiver, Physician office05D0976874
- Clear Recovery CenterCertificate of Waiver, Other05D2307823
- Clear Recovery Center - 1925 W 146th STCertificate of Waiver, Other05D2322374
- Clear Recovery Center, LLCCertificate of Waiver, Other05D2307475
- Clear View Convalescent CenterCertificate of Waiver, Skilled nursing or nursing facility05D2054386
- Clear View Sanitarium, IncCertificate of Waiver, Skilled nursing or nursing facility05D0866691
- Coastal Asian Pacific Islander Family MentalCertificate of Waiver, Community clinic05D2202361
Related
Questions
What is the CLIA number for Dongjin Sung, MD in Gardena?
05D2172564, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Dongjin Sung, MD hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2172564 expire?
The CMS file lists September 24, 2027 as the certificate expiration date; the certificate took effect September 25, 2025.