05D0928544 CLIA NUMBER - DEVAUGHN K PEACE MD

Laboratory Demographics

CLIA Number: 05D0928544

Facility Name: DEVAUGHN K PEACE MD

Facility Address:
4326 S WESTERN AVENUE
LOS ANGELES, CA
ZIP 90062
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Facility Phone Number: 213 299-9914

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1831103779

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	05D0928544
LAB Type	Physician Office
Facility Name	DEVAUGHN K PEACE MD
Street	4326 S WESTERN AVENUE
City	LOS ANGELES
State	CA
ZIP	90062
Phone	213 299-9914
CertificateType	4
CertificateEffectiveDate	5/20/2023
CertificateExpirationDate	5/19/2025
FacilityType	Waiver

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