05D0887841 CLIA NUMBER - JED PADRE MD INC

Laboratory Demographics

  • CLIA Code: 05D0887841
  • Facility Name: JED PADRE MD INC
  • Facility Address: 282 E SEPULVEDA BLVD
    CARSON, CA
    ZIP 90745
  • Facility Phone: 310 518-6861
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JED PADRE
  • NPI Number: 1285169110
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0887841
LAB Type Physician Office
Facility Name JED PADRE MD INC
Street 282 E SEPULVEDA BLVD
City CARSON
State CA
ZIP 90745
Phone 310 518-6861
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Physician Office
Lab Director JED PADRE

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