05D2042370 CLIA NUMBER - THE WALL LAS MEMORIAS PROJECT

Laboratory Demographics

  • CLIA Code: 05D2042370
  • Facility Name: THE WALL LAS MEMORIAS PROJECT
  • Facility Address: 5619 MONTE VISTA ST
    LOS ANGELES, CA
    ZIP 90042
  • Facility Phone: 323 257-1056
  • Facility Type: Health Main. Organization
  • Facility Type: Waiver
  • Lab Director: LUIS ARTAVIA
  • NPI Number: 1649086166
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2042370
LAB Type Health Main. Organization
Facility Name THE WALL LAS MEMORIAS PROJECT
Street 5619 MONTE VISTA ST
City LOS ANGELES
State CA
ZIP 90042
Phone 323 257-1056
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Health Main. Organization
Lab Director LUIS ARTAVIA

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