05D0549875 CLIA NUMBER - UCLA SMBP WILSHIRE

Laboratory Demographics

  • CLIA Code: 05D0549875
  • Facility Name: UCLA SMBP WILSHIRE
  • Facility Address: 2424 WILSHIRE BLVD
    SANTA MONICA, CA
    ZIP 90403
  • Facility Phone: 310 828-4530
  • Facility Type: Other - UC REGENTS-STATE
  • Facility Type: Waiver
  • Lab Director: VLADIMIR G. MANUEL, MD
  • NPI Number: 1700112406
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 05D0549875
LAB Type Other - UC REGENTS-STATE
Facility Name UCLA SMBP WILSHIRE
Street 2424 WILSHIRE BLVD
City SANTA MONICA
State CA
ZIP 90403
Phone 310 828-4530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Other - UC REGENTS-STATE
Lab Director VLADIMIR G. MANUEL, MD

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