05D0953058 CLIA NUMBER - LOUISE H CONNOLLY MD

Laboratory Demographics

  • CLIA Code: 05D0953058
  • Facility Name: LOUISE H CONNOLLY MD
  • Facility Address: 510 N PROSPECT AVE SUITE #306
    REDONDO BEACH, CA
    ZIP 90277
  • Facility Phone: 310 372-4706
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LOUISE H. CONNOLLY
  • NPI Number: 1356421606
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0953058
LAB Type Physician Office
Facility Name LOUISE H CONNOLLY MD
Street 510 N PROSPECT AVE SUITE #306
City REDONDO BEACH
State CA
ZIP 90277
Phone 310 372-4706
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director LOUISE H. CONNOLLY

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