05D0698919 CLIA NUMBER - HARBOR COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 05D0698919
  • Facility Name: HARBOR COMMUNITY CLINIC
  • Facility Address: 593 W 6TH STREET
    SAN PEDRO, CA
    ZIP 90731
  • Facility Phone: 310 547-0202
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: CALEB LUSK
  • NPI Number: 1831739614
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0698919
LAB Type Federally Qualified Health Center
Facility Name HARBOR COMMUNITY CLINIC
Street 593 W 6TH STREET
City SAN PEDRO
State CA
ZIP 90731
Phone 310 547-0202
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 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Federally Qualified Health Center
Lab Director CALEB LUSK

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