05D1033870 CLIA NUMBER - LA FE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D1033870
  • Facility Name: LA FE MEDICAL GROUP
  • Facility Address: 3000 E 1ST ST
    LOS ANGELES, CA
    ZIP 90063
  • Facility Phone: 323 262-6935
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE DIAZ
  • NPI Number: 1609056639
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1033870
LAB Type Physician Office
Facility Name LA FE MEDICAL GROUP
Street 3000 E 1ST ST
City LOS ANGELES
State CA
ZIP 90063
Phone 323 262-6935
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director JOSE DIAZ

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