05D0545311 CLIA NUMBER - LOS ANGELES MEDICAL CENTER

Laboratory Demographics

CLIA Number: 05D0545311

Facility Name: LOS ANGELES MEDICAL CENTER

Facility Address:
2010 WILSHIRE BLVD 2ND FL
LOS ANGELES, CA
ZIP 90057
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Facility Phone Number: 213 483-9209

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1710514930

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0545311
LAB Type	Physician Office
Facility Name	LOS ANGELES MEDICAL CENTER
Street	2010 WILSHIRE BLVD 2ND FL
City	LOS ANGELES
State	CA
ZIP	90057
Phone	213 483-9209
CertificateType	2
CertificateEffectiveDate	12/10/2020
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024