05D0689107 CLIA NUMBER - LONGWOOD MANOR CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0689107
  • Facility Name: LONGWOOD MANOR CONVALESCENT HOSPITAL
  • Facility Address: 4853 W WASHINGTON
    LOS ANGELES, CA
    ZIP 90016
  • Facility Phone: 323 935-1157
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: STEVEN WANG MD
  • NPI Number: 1235213810
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0689107
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LONGWOOD MANOR CONVALESCENT HOSPITAL
Street 4853 W WASHINGTON
City LOS ANGELES
State CA
ZIP 90016
Phone 323 935-1157
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2023
Certificate Expiration Date 11/22/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director STEVEN WANG MD

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