05D2102128 CLIA NUMBER - ALTAMED MEDICAL GROUP - HUNTINGTON PARK

Laboratory Demographics

  • CLIA Code: 05D2102128
  • Facility Name: ALTAMED MEDICAL GROUP - HUNTINGTON PARK
  • Facility Address: 1900 E. SLAUSON AVENUE STE 205
    HUNTINGTON PARK, CA
    ZIP 90255
  • Facility Phone: 323 487-4110
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: FRANCIS RUNAS
  • NPI Number: 1790177582
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2102128
LAB Type Federally Qualified Health Center
Facility Name ALTAMED MEDICAL GROUP - HUNTINGTON PARK
Street 1900 E. SLAUSON AVENUE STE 205
City HUNTINGTON PARK
State CA
ZIP 90255
Phone 323 487-4110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Federally Qualified Health Center
Lab Director FRANCIS RUNAS

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