05D0895902 CLIA NUMBER - MEADOWBROOK MANOR

Laboratory Demographics

  • CLIA Code: 05D0895902
  • Facility Name: MEADOWBROOK MANOR
  • Facility Address: 3951 EAST BLVD
    LOS ANGELES, CA
    ZIP 90048
  • Facility Phone: 310 391-8266
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BARBARA OCONNOR
  • NPI Number: 1891742946
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0895902
LAB Type Physician Office
Facility Name MEADOWBROOK MANOR
Street 3951 EAST BLVD
City LOS ANGELES
State CA
ZIP 90048
Phone 310 391-8266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Physician Office
Lab Director BARBARA OCONNOR

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This page was last updated on: 6/4/2025