05D0540423 CLIA NUMBER - SAMUEL J PORTER MD A MEDICAL CORP

Laboratory Demographics

  • CLIA Code: 05D0540423
  • Facility Name: SAMUEL J PORTER MD A MEDICAL CORP
  • Facility Address: 321 N LARCHMONT, SUITE 618
    LOS ANGELES, CA
    ZIP 90004
  • Facility Phone: 323 469-7133
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAMUEL J. PORTER
  • NPI Number: 1366500209
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0540423
LAB Type Physician Office
Facility Name SAMUEL J PORTER MD A MEDICAL CORP
Street 321 N LARCHMONT, SUITE 618
City LOS ANGELES
State CA
ZIP 90004
Phone 323 469-7133
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director SAMUEL J. PORTER

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