05D0931714 CLIA NUMBER - ADVENTIST HEALTH / WHITE MEMORIAL MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0931714
  • Facility Name: ADVENTIST HEALTH / WHITE MEMORIAL MEDICAL GROUP
  • Facility Address: 1701 E CESAR CHAVEZ AVENUE STE 510
    LOS ANGELES, CA
    ZIP 90033
  • Facility Phone: 323 987-1362
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VASTHI SILVA
  • NPI Number: 1063892867
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0931714
LAB Type Physician Office
Facility Name ADVENTIST HEALTH / WHITE MEMORIAL MEDICAL GROUP
Street 1701 E CESAR CHAVEZ AVENUE STE 510
City LOS ANGELES
State CA
ZIP 90033
Phone 323 987-1362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Physician Office
Lab Director VASTHI SILVA

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