05D1065039 CLIA NUMBER - LILY BALETTE MD

Laboratory Demographics

  • CLIA Code: 05D1065039
  • Facility Name: LILY BALETTE MD
  • Facility Address: 1141 W REDONDO BEACH BLVD STE 211
    GARDENA, CA
    ZIP 90247
  • Facility Phone: 310 327-0245
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LILY BALETTE MD
  • NPI Number: 1902960388
  • Taxonomy: 2080N0001X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D1065039
LAB Type Physician Office
Facility Name LILY BALETTE MD
Street 1141 W REDONDO BEACH BLVD STE 211
City GARDENA
State CA
ZIP 90247
Phone 310 327-0245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Physician Office
Lab Director LILY BALETTE MD

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