05D0969901 CLIA NUMBER - LUIS HERNANDEZ MD

Laboratory Demographics

  • CLIA Code: 05D0969901
  • Facility Name: LUIS HERNANDEZ MD
  • Facility Address: 1817 BEVERLY BVD
    MONTEBELLO, CA
    ZIP 90640
  • Facility Phone: 323 721-5524
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HERNANDEZ LUIS MD
  • NPI Number: 1619152113
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0969901
LAB Type Physician Office
Facility Name LUIS HERNANDEZ MD
Street 1817 BEVERLY BVD
City MONTEBELLO
State CA
ZIP 90640
Phone 323 721-5524
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Physician Office
Lab Director HERNANDEZ LUIS MD

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