05D0703037 CLIA NUMBER - JOHN M HERNANDEZ MD INC

Laboratory Demographics

  • CLIA Code: 05D0703037
  • Facility Name: JOHN M HERNANDEZ MD INC
  • Facility Address: 1417 W BEVERLY BLVD STE 101
    MONTEBELLO, CA
    ZIP 90640
  • Facility Phone: 323 726-1109
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN M. HERNANDEZ
  • NPI Number: 1073683546
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0703037
LAB Type Physician Office
Facility Name JOHN M HERNANDEZ MD INC
Street 1417 W BEVERLY BLVD STE 101
City MONTEBELLO
State CA
ZIP 90640
Phone 323 726-1109
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 JOHN M. HERNANDEZ

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