05D0928544 CLIA NUMBER - DEVAUGHN K PEACE MD

Laboratory Demographics

  • CLIA Code: 05D0928544
  • Facility Name: DEVAUGHN K PEACE MD
  • Facility Address: 4326 S WESTERN AVENUE
    LOS ANGELES, CA
    ZIP 90062
  • Facility Phone: (213) 299-9914
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEVAUGHN PEACE
  • NPI Number: 1831103779
  • Taxonomy: 208000000X - Pediatrics

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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 2132999914
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Physician Office
Lab Director DEVAUGHN PEACE

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This page was last updated on: 5/18/2026