05D0594731 CLIA NUMBER - PACIFIC PEDIATRICS MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0594731
  • Facility Name: PACIFIC PEDIATRICS MEDICAL GROUP INC
  • Facility Address: 45 CASTRO STREET SUITE 232
    SAN FRANCISCO, CA
    ZIP 94114
  • Facility Phone: 415 565-6810
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BARRY R. ROSTEK , DO
  • NPI Number: 1366539884
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0594731
LAB Type Physician Office
Facility Name PACIFIC PEDIATRICS MEDICAL GROUP INC
Street 45 CASTRO STREET SUITE 232
City SAN FRANCISCO
State CA
ZIP 94114
Phone 415 565-6810
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 Physician Office
Lab Director BARRY R. ROSTEK , DO

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