05D0864224 CLIA NUMBER - HOLY TRINITY MEDICAL CLINIC OFFICE LAB

Laboratory Demographics

CLIA Number: 05D0864224

Facility Name: HOLY TRINITY MEDICAL CLINIC OFFICE LAB

Facility Address:
1310 W SEPULVEDA BLVD
HARBOR CITY, CA
ZIP 90710
Get Directions

Facility Phone Number: 310 534-5765

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1033398136

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	05D0864224
LAB Type	Physician Office
Facility Name	HOLY TRINITY MEDICAL CLINIC OFFICE LAB
Street	1310 W SEPULVEDA BLVD
City	HARBOR CITY
State	CA
ZIP	90710
Phone	310 534-5765
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024