05D0545394 CLIA NUMBER - MARTIN LUTHER KING, JR. OUTPATIENT CENTER

Laboratory Demographics

  • CLIA Code: 05D0545394
  • Facility Name: MARTIN LUTHER KING, JR. OUTPATIENT CENTER
  • Facility Address: 1670 E. 120TH STREET AFH BLDG RM 3046
    LOS ANGELES, CA
    ZIP 90059
  • Facility Phone: 424 338-1370
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Accreditation
  • Lab Director: DR. MELANIE A. OSBY
  • NPI Number: 1962811265
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0545394
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MARTIN LUTHER KING, JR. OUTPATIENT CENTER
Street 1670 E. 120TH STREET AFH BLDG RM 3046
City LOS ANGELES
State CA
ZIP 90059
Phone 424 338-1370
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. MELANIE A. OSBY

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