05D0984018 CLIA NUMBER - HEATHER J ROBERTS MD, A MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D0984018
  • Facility Name: HEATHER J ROBERTS MD, A MEDICAL CORPORATION
  • Facility Address: 11500 W. OLYMPIC BL. #480
    LOS ANGELES, CA
    ZIP 90064
  • Facility Phone: 310 477-4727
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: HEATHER J. ROBERTS MD
  • NPI Number: 1629171624
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0984018
LAB Type Physician Office
Facility Name HEATHER J ROBERTS MD, A MEDICAL CORPORATION
Street 11500 W. OLYMPIC BL. #480
City LOS ANGELES
State CA
ZIP 90064
Phone 310 477-4727
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 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Physician Office
Lab Director HEATHER J. ROBERTS MD

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