05D2029347 CLIA NUMBER - STUDENT HEALTH CENTER LOS ANGELES HARBOR COLLEGE

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Laboratory Demographics

CLIA Number: 05D2029347

Facility Name: STUDENT HEALTH CENTER LOS ANGELES HARBOR COLLEGE

Facility Address:
1111 FIGUEROA PLACE-CAFE 110
WILMINGTON, CA
ZIP 90744
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Facility Phone Number: 310 233-4520

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1376960971

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2029347
LAB Type	School/Student Health Service
Facility Name	STUDENT HEALTH CENTER LOS ANGELES HARBOR COLLEGE
Street	1111 FIGUEROA PLACE-CAFE 110
City	WILMINGTON
State	CA
ZIP	90744
Phone	310 233-4520
CertificateType	4
CertificateEffectiveDate	9/6/2023
CertificateExpirationDate	9/5/2025
FacilityType	Waiver

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