05D1065099 CLIA NUMBER - PLAZA TOWERS OBSTETRICS & GYNECOLOGY

Laboratory Demographics

  • CLIA Code: 05D1065099
  • Facility Name: PLAZA TOWERS OBSTETRICS & GYNECOLOGY
  • Facility Address: 2001 SANTA MONICA BLVD STE 468W
    SANTA MONICA, CA
    ZIP 90404
  • Facility Phone: 310 255-0990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAWRENCE M. BRUKSCH
  • NPI Number: 1235179037
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D1065099
LAB Type Physician Office
Facility Name PLAZA TOWERS OBSTETRICS & GYNECOLOGY
Street 2001 SANTA MONICA BLVD STE 468W
City SANTA MONICA
State CA
ZIP 90404
Phone 310 255-0990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2024
Certificate Expiration Date 1/1/2026
Facility Type Physician Office
Lab Director LAWRENCE M. BRUKSCH

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