05D0549005 CLIA NUMBER - VENICE FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 05D0549005
  • Facility Name: VENICE FAMILY CLINIC
  • Facility Address: 604 ROSE AVENUE
    VENICE, CA
    ZIP 90291
  • Facility Phone: 310 664-7667
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: BLANCA G. ANDRES
  • NPI Number: 1982154308
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D0549005
LAB Type Federally Qualified Health Center
Facility Name VENICE FAMILY CLINIC
Street 604 ROSE AVENUE
City VENICE
State CA
ZIP 90291
Phone 310 664-7667
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 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Federally Qualified Health Center
Lab Director BLANCA G. ANDRES

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