05D1079213 CLIA NUMBER - HUNTINGTON PARK FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D1079213

Facility Name: HUNTINGTON PARK FAMILY HEALTH CENTER

Facility Address:
2680 SATURN AVE STE 110
HUNTINGTON PARK, CA
ZIP 90255
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Facility Phone Number: 323 908-4000

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1750821732

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1079213
LAB Type	Federally Qualified Health Center
Facility Name	HUNTINGTON PARK FAMILY HEALTH CENTER
Street	2680 SATURN AVE STE 110
City	HUNTINGTON PARK
State	CA
ZIP	90255
Phone	323 908-4000
CertificateType	3
CertificateEffectiveDate	12/15/2023
CertificateExpirationDate	12/14/2025
FacilityType	PPMP

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