05D2171967 CLIA NUMBER - ALTAMED ADULT WESTLAKE, 3RD STREET

Laboratory Demographics

  • CLIA Code: 05D2171967
  • Facility Name: ALTAMED ADULT WESTLAKE, 3RD STREET
  • Facility Address: 2100 WEST 3RD ST, SUITE 400
    LOS ANGELES, CA
    ZIP 90057
  • Facility Phone: 888 499-9303
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: CARLOS YOO
  • NPI Number: 1407109580
  • Taxonomy: 174H00000X - Health Educator

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CLIA Record

Field Name Field Value
CLIA Number 05D2171967
LAB Type Federally Qualified Health Center
Facility Name ALTAMED ADULT WESTLAKE, 3RD STREET
Street 2100 WEST 3RD ST, SUITE 400
City LOS ANGELES
State CA
ZIP 90057
Phone 888 499-9303
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Federally Qualified Health Center
Lab Director CARLOS YOO

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