05D2009629 CLIA NUMBER - PHILIP M BRETSKY, MD PHD

Laboratory Demographics

  • CLIA Code: 05D2009629
  • Facility Name: PHILIP M BRETSKY, MD PHD
  • Facility Address: 1301 20TH ST STE 230
    SANTA MONICA, CA
    ZIP 90404
  • Facility Phone: 310 828-4411
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILIP M. BRETSKY MD
  • NPI Number: 1568683076
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2009629
LAB Type Physician Office
Facility Name PHILIP M BRETSKY, MD PHD
Street 1301 20TH ST STE 230
City SANTA MONICA
State CA
ZIP 90404
Phone 310 828-4411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Physician Office
Lab Director PHILIP M. BRETSKY MD

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