05D2279187 CLIA NUMBER - PACIFICA FOUNDATION, LLC

Laboratory Demographics

  • CLIA Code: 05D2279187
  • Facility Name: PACIFICA FOUNDATION, LLC
  • Facility Address: 1300 N VERMONT AVE, #407
    LOS ANGELES, CA
    ZIP 90027
  • Facility Phone: 323 913-4200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BEN HA
  • NPI Number: 1356998272
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2279187
LAB Type Physician Office
Facility Name PACIFICA FOUNDATION, LLC
Street 1300 N VERMONT AVE, #407
City LOS ANGELES
State CA
ZIP 90027
Phone 323 913-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Physician Office
Lab Director BEN HA

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