05D1040943 CLIA NUMBER - EL SERENO MEDICAL GROUP

Laboratory Demographics

CLIA Number: 05D1040943

Facility Name: EL SERENO MEDICAL GROUP

Facility Address:
3301 NORTH EASTERN AVENUE
LOS ANGELES, CA
ZIP 90032
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Facility Phone Number: 323 225-2351

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336189117

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D1040943
LAB Type	Physician Office
Facility Name	EL SERENO MEDICAL GROUP
Street	3301 NORTH EASTERN AVENUE
City	LOS ANGELES
State	CA
ZIP	90032
Phone	323 225-2351
CertificateType	4
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	Waiver

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