05D1013580 CLIA NUMBER - KINGSLEY PLACE ADHC II

Laboratory Demographics

  • CLIA Code: 05D1013580
  • Facility Name: KINGSLEY PLACE ADHC II
  • Facility Address: 1225 JAMES M. WOOD BLVD
    LOS ANGELES, CA
    ZIP 90015
  • Facility Phone: 213 387-9097
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JOONG Y. PARK
  • NPI Number: 1881819837
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1013580
LAB Type Other
Facility Name KINGSLEY PLACE ADHC II
Street 1225 JAMES M. WOOD BLVD
City LOS ANGELES
State CA
ZIP 90015
Phone 213 387-9097
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2025
Certificate Expiration Date 6/10/2027
Facility Type Other
Lab Director JOONG Y. PARK

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