05D0887597 CLIA NUMBER - GRAND PARK CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0887597
  • Facility Name: GRAND PARK CONVALESCENT HOSPITAL
  • Facility Address: 2312 WEST 8TH STREET
    LOS ANGELES, CA
    ZIP 90057
  • Facility Phone: 213 382-7315
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: F E. POWELL MD
  • NPI Number: 1043251622
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0887597
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GRAND PARK CONVALESCENT HOSPITAL
Street 2312 WEST 8TH STREET
City LOS ANGELES
State CA
ZIP 90057
Phone 213 382-7315
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director F E. POWELL MD

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