05D0590848 CLIA NUMBER - PACIFIC GROVE CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0590848
  • Facility Name: PACIFIC GROVE CONVALESCENT HOSPITAL
  • Facility Address: 200 LIGHTHOUSE AVE
    PACIFIC GROVE, CA
    ZIP 93950
  • Facility Phone: 408 375-2695
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: NINA F. ROBERTS
  • NPI Number: 1740846260
  • Taxonomy: 171100000X - Acupuncturist

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CLIA Record

Field Name Field Value
CLIA Number 05D0590848
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PACIFIC GROVE CONVALESCENT HOSPITAL
Street 200 LIGHTHOUSE AVE
City PACIFIC GROVE
State CA
ZIP 93950
Phone 408 375-2695
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director NINA F. ROBERTS

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