05D1021700 CLIA NUMBER - ALTAMED MEDICAL AND DENTAL GROUP - WHITTIER WEST

Laboratory Demographics

  • CLIA Code: 05D1021700
  • Facility Name: ALTAMED MEDICAL AND DENTAL GROUP - WHITTIER WEST
  • Facility Address: 3945 E WHITTIER BLVD
    LOS ANGELES, CA
    ZIP 90023
  • Facility Phone: 213 472-0200
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DAVID ESCOBAR
  • NPI Number: 1679973085
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 05D1021700
LAB Type Federally Qualified Health Center
Facility Name ALTAMED MEDICAL AND DENTAL GROUP - WHITTIER WEST
Street 3945 E WHITTIER BLVD
City LOS ANGELES
State CA
ZIP 90023
Phone 213 472-0200
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 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Federally Qualified Health Center
Lab Director DAVID ESCOBAR

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