05D2107123 CLIA NUMBER - MODMD, APC

Laboratory Demographics

  • CLIA Code: 05D2107123
  • Facility Name: MODMD, APC
  • Facility Address: 208 LINCOLN BLVD
    VENICE, CA
    ZIP 90291
  • Facility Phone: 833 663-6399
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. MAGGIE HOPKINS
  • NPI Number: 1124328430
  • Taxonomy: 207RA0401X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2107123
LAB Type Independent
Facility Name MODMD, APC
Street 208 LINCOLN BLVD
City VENICE
State CA
ZIP 90291
Phone 833 663-6399
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Independent
Lab Director DR. MAGGIE HOPKINS

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