05D1028342 CLIA NUMBER - BEVERLYCARE

Laboratory Demographics

CLIA Number: 05D1028342

Facility Name: BEVERLYCARE

Facility Address:
1920 W WHITTIER BLVD
MONTEBELLO, CA
ZIP 90640
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Facility Phone Number: 323 725-1519

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1114562287

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1028342
LAB Type	Community Clinic
Facility Name	BEVERLYCARE
Street	1920 W WHITTIER BLVD
City	MONTEBELLO
State	CA
ZIP	90640
Phone	323 725-1519
CertificateType	3
CertificateEffectiveDate	7/22/2022
CertificateExpirationDate	7/21/2024
FacilityType	PPMP

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