05D1069575 CLIA NUMBER - ST LUKE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D1069575
  • Facility Name: ST LUKE MEDICAL CLINIC
  • Facility Address: 5912 SANTA MONICA BLVD
    LOS ANGELES, CA
    ZIP 90038
  • Facility Phone: 323 461-3888
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICHOLAS ROGERS
  • NPI Number: 1487832655
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1069575
LAB Type Physician Office
Facility Name ST LUKE MEDICAL CLINIC
Street 5912 SANTA MONICA BLVD
City LOS ANGELES
State CA
ZIP 90038
Phone 323 461-3888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Physician Office
Lab Director NICHOLAS ROGERS

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