05D0724482 CLIA NUMBER - PACIFIC VILLA, INC

Laboratory Demographics

  • CLIA Code: 05D0724482
  • Facility Name: PACIFIC VILLA, INC
  • Facility Address: 3501 CEDAR AVENUE
    LONG BEACH, CA
    ZIP 90807
  • Facility Phone: 562 595-1731
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RONALD PHILIPP, MD
  • NPI Number: 1447656566
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0724482
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PACIFIC VILLA, INC
Street 3501 CEDAR AVENUE
City LONG BEACH
State CA
ZIP 90807
Phone 562 595-1731
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 RONALD PHILIPP, MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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