05D0722348 CLIA NUMBER - ROBERTA J SMITH MD

Laboratory Demographics

  • CLIA Code: 05D0722348
  • Facility Name: ROBERTA J SMITH MD
  • Facility Address: 970 MONUMENT ST
    PACIFIC PALISADES, CA
    ZIP 90272
  • Facility Phone: 310 459-4321
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBERTA J. SMITH
  • NPI Number: 1164532750
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0722348
LAB Type Physician Office
Facility Name ROBERTA J SMITH MD
Street 970 MONUMENT ST
City PACIFIC PALISADES
State CA
ZIP 90272
Phone 310 459-4321
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 ROBERTA J. SMITH

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