05D0549694 CLIA NUMBER - TENTH STREET PEDIATRIC MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0549694
  • Facility Name: TENTH STREET PEDIATRIC MEDICAL GROUP INC
  • Facility Address: 1450 10TH ST STE 304
    SANTA MONICA, CA
    ZIP 90401
  • Facility Phone: 310 458-1714
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LISA C. STERN MD
  • NPI Number: 1295126431
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0549694
LAB Type Physician Office
Facility Name TENTH STREET PEDIATRIC MEDICAL GROUP INC
Street 1450 10TH ST STE 304
City SANTA MONICA
State CA
ZIP 90401
Phone 310 458-1714
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director LISA C. STERN MD

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