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05D2010019 CLIA NUMBER - GOLDEN STATE SPORTS INJURY & ORTHOPEDIC MEDICAL ASSOCIATES, INC

Laboratory Demographics

CLIA Number: 05D2010019

Facility Name: GOLDEN STATE SPORTS INJURY & ORTHOPEDIC MEDICAL ASSOCIATES, INC

Facility Address:
12321 S HAWTHORNE BLVD STE C
HAWTHORNE, CA
ZIP 90250
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Facility Phone Number: 818 998-8400

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1770643645

Taxonomy: 207X00000X - Orthopaedic Surgery
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

CLIA Record

Field Name Field Value
CLIA Number 05D2010019
LAB Type Physician Office
Facility Name GOLDEN STATE SPORTS INJURY & ORTHOPEDIC MEDICAL ASSOCIATES, INC
Street 12321 S HAWTHORNE BLVD STE C
City HAWTHORNE
State CA
ZIP 90250
Phone 818 998-8400
CertificateType 4
CertificateEffectiveDate 7/19/2022
CertificateExpirationDate 7/18/2024
FacilityType Waiver

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