05D0993028 CLIA NUMBER - KINGSLEY PLACE ADHC

Laboratory Demographics

  • CLIA Code: 05D0993028
  • Facility Name: KINGSLEY PLACE ADHC
  • Facility Address: 548 S KINGSLEY DR
    LOS ANGELES, CA
    ZIP 90020
  • Facility Phone: 213 383-3303
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: JOONG Y. PARK
  • NPI Number: 1285859249
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0993028
LAB Type Ancillary Testing Site in Health Care Center
Facility Name KINGSLEY PLACE ADHC
Street 548 S KINGSLEY DR
City LOS ANGELES
State CA
ZIP 90020
Phone 213 383-3303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director JOONG Y. PARK

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