05D1012485 CLIA NUMBER - FELICES DIAS

Laboratory Demographics

CLIA Number: 05D1012485

Facility Name: FELICES DIAS

Facility Address:
2309 S FLOWER STREET
LOS ANGELES, CA
ZIP 90007
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Facility Phone Number: 213 746-6611

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1689891301

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1012485
LAB Type	Other
Facility Name	FELICES DIAS
Street	2309 S FLOWER STREET
City	LOS ANGELES
State	CA
ZIP	90007
Phone	213 746-6611
CertificateType	4
CertificateEffectiveDate	5/12/2023
CertificateExpirationDate	5/11/2025
FacilityType	Waiver

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