05D0683042 CLIA NUMBER - IMPERIAL BEACH HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 05D0683042
  • Facility Name: IMPERIAL BEACH HEALTH CENTER
  • Facility Address: 949 PALM AVENUE
    IMPERIAL BEACH, CA
    ZIP 91932
  • Facility Phone: 619 429-3733
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: ERIC LEUTE, MD
  • NPI Number: 1790718351
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0683042
LAB Type Community Clinic
Facility Name IMPERIAL BEACH HEALTH CENTER
Street 949 PALM AVENUE
City IMPERIAL BEACH
State CA
ZIP 91932
Phone 619 429-3733
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Community Clinic
Lab Director ERIC LEUTE, MD

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