05D0676352 CLIA NUMBER - COSTA DEL SOL HEALTHCARE

Laboratory Demographics

  • CLIA Code: 05D0676352
  • Facility Name: COSTA DEL SOL HEALTHCARE
  • Facility Address: 1016 S RECORD AVE
    LOS ANGELES, CA
    ZIP 90023
  • Facility Phone: 323 826-5035
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MOHAMAD ALBOUIDANI
  • NPI Number: 1780680967
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0676352
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name COSTA DEL SOL HEALTHCARE
Street 1016 S RECORD AVE
City LOS ANGELES
State CA
ZIP 90023
Phone 323 826-5035
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 MOHAMAD ALBOUIDANI

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