05D0884121 CLIA NUMBER - LOS PALOS CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0884121
  • Facility Name: LOS PALOS CONVALESCENT HOSPITAL
  • Facility Address: 1430 WEST 6TH STREET
    SAN PEDRO, CA
    ZIP 90732
  • Facility Phone: 310 832-6431
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JAMES SCHMIDT
  • NPI Number: 1306914775
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0884121
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LOS PALOS CONVALESCENT HOSPITAL
Street 1430 WEST 6TH STREET
City SAN PEDRO
State CA
ZIP 90732
Phone 310 832-6431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JAMES SCHMIDT

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