05D2202263 CLIA NUMBER - HOLLYWOOD MENTAL HEALTH FSP

Laboratory Demographics

  • CLIA Code: 05D2202263
  • Facility Name: HOLLYWOOD MENTAL HEALTH FSP
  • Facility Address: 947 COLE AVE
    LOS ANGELES, CA
    ZIP 90038
  • Facility Phone: 213 738-4725
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: PRATIK MEHTA
  • NPI Number: 1124261144
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2202263
LAB Type Community Clinic
Facility Name HOLLYWOOD MENTAL HEALTH FSP
Street 947 COLE AVE
City LOS ANGELES
State CA
ZIP 90038
Phone 213 738-4725
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2024
Certificate Expiration Date 11/24/2026
Facility Type Community Clinic
Lab Director PRATIK MEHTA

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