05D0711840 CLIA NUMBER - RICKY S ONOFRE-VASQUEZ MD

Laboratory Demographics

  • CLIA Code: 05D0711840
  • Facility Name: RICKY S ONOFRE-VASQUEZ MD
  • Facility Address: 12099 W WASHINGTON BLVD STE 202
    LOS ANGELES, CA
    ZIP 90066
  • Facility Phone: 310 572-6225
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICKY S. ONOFRE-VASQUEZ
  • NPI Number: 1750353892
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0711840
LAB Type Physician Office
Facility Name RICKY S ONOFRE-VASQUEZ MD
Street 12099 W WASHINGTON BLVD STE 202
City LOS ANGELES
State CA
ZIP 90066
Phone 310 572-6225
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director RICKY S. ONOFRE-VASQUEZ

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