05D0550045 CLIA NUMBER - KIDS AND TEENS MEDICAL GROUP - JANESRI DE SILVA, MD

Laboratory Demographics

  • CLIA Code: 05D0550045
  • Facility Name: KIDS AND TEENS MEDICAL GROUP - JANESRI DE SILVA, MD
  • Facility Address: 3200 SANTA MONICA BLVD, #204
    SANTA MONICA, CA
    ZIP 90404
  • Facility Phone: 818 361-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JANESRI DE SILVA
  • NPI Number: 1639180623
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0550045
LAB Type Physician Office
Facility Name KIDS AND TEENS MEDICAL GROUP - JANESRI DE SILVA, MD
Street 3200 SANTA MONICA BLVD, #204
City SANTA MONICA
State CA
ZIP 90404
Phone 818 361-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JANESRI DE SILVA

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