05D2003801 CLIA NUMBER - MARCIL M MAMITA, MD A MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2003801
  • Facility Name: MARCIL M MAMITA, MD A MEDICAL CORPORATION
  • Facility Address: 3655 LOMITA BLVD STE 418
    TORRANCE, CA
    ZIP 90505
  • Facility Phone: 310 530-6900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARCIL M. MAMITA
  • NPI Number: 1962412718
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2003801
LAB Type Physician Office
Facility Name MARCIL M MAMITA, MD A MEDICAL CORPORATION
Street 3655 LOMITA BLVD STE 418
City TORRANCE
State CA
ZIP 90505
Phone 310 530-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Physician Office
Lab Director DR. MARCIL M. MAMITA

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