05D0605433 CLIA NUMBER - PACIFIC COAST MANOR

Laboratory Demographics

  • CLIA Code: 05D0605433
  • Facility Name: PACIFIC COAST MANOR
  • Facility Address: 1935 WHARF RD
    CAPITOLA, CA
    ZIP 95010
  • Facility Phone: 831 476-0770
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT C. POTTS JR MD
  • NPI Number: 1609874163
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0605433
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PACIFIC COAST MANOR
Street 1935 WHARF RD
City CAPITOLA
State CA
ZIP 95010
Phone 831 476-0770
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 ROBERT C. POTTS JR MD

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