Healther Providers Data Logo

05D0975886 CLIA NUMBER - ST JOHN'S URGENT CARE & MEDICAL CORPORATION

Laboratory Demographics

CLIA Number: 05D0975886

Facility Name: ST JOHN'S URGENT CARE & MEDICAL CORPORATION

Facility Address:
1119 N WESTERN AVENUE, SUITE G
LOS ANGELES, CA
ZIP 90029
Get Directions

Facility Phone Number: 323 957-9300

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1023524980

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name Field Value
CLIA Number 05D0975886
LAB Type Physician Office
Facility Name ST JOHN'S URGENT CARE & MEDICAL CORPORATION
Street 1119 N WESTERN AVENUE, SUITE G
City LOS ANGELES
State CA
ZIP 90029
Phone 323 957-9300
CertificateType 4
CertificateEffectiveDate 7/20/2022
CertificateExpirationDate 7/19/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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