05D0693311 CLIA NUMBER - VISTA LA MESA SENIOR LIVING, INC

Laboratory Demographics

  • CLIA Code: 05D0693311
  • Facility Name: VISTA LA MESA SENIOR LIVING, INC
  • Facility Address: 5480 MARENGO AVE
    LA MESA, CA
    ZIP 91942
  • Facility Phone: 619 463-0281
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BRIJ GUPTA MD
  • NPI Number: 1013623073
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0693311
LAB Type Assisted Living Facility
Facility Name VISTA LA MESA SENIOR LIVING, INC
Street 5480 MARENGO AVE
City LA MESA
State CA
ZIP 91942
Phone 619 463-0281
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 Assisted Living Facility
Lab Director BRIJ GUPTA MD

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