05D2044682 CLIA NUMBER - ALTAMED MEDICAL & DENTAL GROUP

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Laboratory Demographics

CLIA Number: 05D2044682

Facility Name: ALTAMED MEDICAL & DENTAL GROUP

Facility Address:
2219 E. 1ST STREET
LOS ANGELES, CA
ZIP 90033
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Facility Phone Number: (323) 647-6202

Facility Type: COMMUNITY CLINIC

Certificate Type: Waiver

NPI Number: 1134492937

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2044682
LAB Type	COMMUNITY CLINIC
Facility Name	ALTAMED MEDICAL & DENTAL GROUP
Street	2219 E. 1ST STREET
City	LOS ANGELES
State	CA
ZIP	90033
Phone	(323) 647-6202

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This page was last updated on: 5/11/2023