05D2142727 CLIA NUMBER - MOBILE MEDICAL LA, LLC

Laboratory Demographics

  • CLIA Code: 05D2142727
  • Facility Name: MOBILE MEDICAL LA, LLC
  • Facility Address: 6818 S. LA CIENEGA BLVD STE 203
    INGLEWOOD, CA
    ZIP 90302
  • Facility Phone: 213 545-6652
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ANDREW WILSON, MD
  • NPI Number: 1083061626
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2142727
LAB Type Home Health Agency
Facility Name MOBILE MEDICAL LA, LLC
Street 6818 S. LA CIENEGA BLVD STE 203
City INGLEWOOD
State CA
ZIP 90302
Phone 213 545-6652
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Home Health Agency
Lab Director ANDREW WILSON, MD

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