05D0717019 CLIA NUMBER - CENTER 4 HEALTH MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0717019
  • Facility Name: CENTER 4 HEALTH MEDICAL GROUP
  • Facility Address: 3762 SANTA ROSALIA DR #C30
    LOS ANGELES, CA
    ZIP 90008
  • Facility Phone: 323 290-2107
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ELIZABETH J. COVINGTON
  • NPI Number: 1346350386
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0717019
LAB Type Physician Office
Facility Name CENTER 4 HEALTH MEDICAL GROUP
Street 3762 SANTA ROSALIA DR #C30
City LOS ANGELES
State CA
ZIP 90008
Phone 323 290-2107
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 ELIZABETH J. COVINGTON

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