05D0581058 CLIA NUMBER - SOUTH COAST PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D0581058
  • Facility Name: SOUTH COAST PEDIATRICS
  • Facility Address: 2650 SOUTH BRISTOL, SUITE #101
    SANTA ANA, CA
    ZIP 92704
  • Facility Phone: 714 754-1444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACOB WOLSZTEJN
  • NPI Number: 1568495364
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0581058
LAB Type Physician Office
Facility Name SOUTH COAST PEDIATRICS
Street 2650 SOUTH BRISTOL, SUITE #101
City SANTA ANA
State CA
ZIP 92704
Phone 714 754-1444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director JACOB WOLSZTEJN

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