05D2193966 CLIA NUMBER - JAY N GORDON MD FAAP

Laboratory Demographics

  • CLIA Code: 05D2193966
  • Facility Name: JAY N GORDON MD FAAP
  • Facility Address: 501 10TH ST
    SANTA MONICA, CA
    ZIP 90402
  • Facility Phone: 310 393-9784
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAY N. GORDON
  • NPI Number: 1952439341
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2193966
LAB Type Physician Office
Facility Name JAY N GORDON MD FAAP
Street 501 10TH ST
City SANTA MONICA
State CA
ZIP 90402
Phone 310 393-9784
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Physician Office
Lab Director JAY N. GORDON

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