05D1025741 CLIA NUMBER - MARTHA G VIDAL MD

Laboratory Demographics

  • CLIA Code: 05D1025741
  • Facility Name: MARTHA G VIDAL MD
  • Facility Address: 11502 S VERMONT AVENUE #B
    LOS ANGELES, CA
    ZIP 90044
  • Facility Phone: 323 755-5500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARTHA VIDAL MD
  • NPI Number: 1437248630
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D1025741
LAB Type Physician Office
Facility Name MARTHA G VIDAL MD
Street 11502 S VERMONT AVENUE #B
City LOS ANGELES
State CA
ZIP 90044
Phone 323 755-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Physician Office
Lab Director MARTHA VIDAL MD

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