05D2076081 CLIA NUMBER - LARCHMONT PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D2076081
  • Facility Name: LARCHMONT PEDIATRICS
  • Facility Address: 321 N LARCHMONT BLVD STE 1020
    LOS ANGELES, CA
    ZIP 90004
  • Facility Phone: 323 960-8500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NEVILLE W. ANDERSON, MD
  • NPI Number: 1821413592
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2076081
LAB Type Physician Office
Facility Name LARCHMONT PEDIATRICS
Street 321 N LARCHMONT BLVD STE 1020
City LOS ANGELES
State CA
ZIP 90004
Phone 323 960-8500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Physician Office
Lab Director NEVILLE W. ANDERSON, MD

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