05D2297477 CLIA NUMBER - DR.PAUL'S IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 05D2297477
  • Facility Name: DR.PAUL'S IMMEDIATE CARE
  • Facility Address: 1812 ARTESIA BLVD
    REDONDO BEACH, CA
    ZIP 90278
  • Facility Phone: 310 374-5600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUSSELL P. KNITTEL
  • NPI Number: 1982036729
  • Taxonomy: 207PE0004X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2297477
LAB Type Physician Office
Facility Name DR.PAUL'S IMMEDIATE CARE
Street 1812 ARTESIA BLVD
City REDONDO BEACH
State CA
ZIP 90278
Phone 310 374-5600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Physician Office
Lab Director RUSSELL P. KNITTEL

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