05D1028342 CLIA NUMBER - BEVERLYCARE

Laboratory Demographics

  • CLIA Code: 05D1028342
  • Facility Name: BEVERLYCARE
  • Facility Address: 1920 W WHITTIER BLVD
    MONTEBELLO, CA
    ZIP 90640
  • Facility Phone: 323 725-1519
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: KENNETH L. COHEN
  • NPI Number: 1114562287
  • Taxonomy: 261QF0400X - Clinic/Center

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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
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 7/22/2024
Certificate Expiration Date 7/21/2026
Facility Type Community Clinic
Lab Director KENNETH L. COHEN

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