05D2193916 CLIA NUMBER - APEX MULTISPECIALTY MEDICAL GROUP

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Laboratory Demographics

CLIA Number: 05D2193916

Facility Name: APEX MULTISPECIALTY MEDICAL GROUP

Facility Address:
600 S SAN VICENTE BLVD
LOS ANGELES, CA
ZIP 90046
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Facility Phone Number: 310 873-3312

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023672367

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2193916
LAB Type	Physician Office
Facility Name	APEX MULTISPECIALTY MEDICAL GROUP
Street	600 S SAN VICENTE BLVD
City	LOS ANGELES
State	CA
ZIP	90046
Phone	310 873-3312
CertificateType	4
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024