05D0876039 CLIA NUMBER - PEPPERDINE UNIVERSITY STUDENT HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D0876039

Facility Name: PEPPERDINE UNIVERSITY STUDENT HEALTH CENTER

Facility Address:
24255 PACIFIC COAST HIGHWAY
MALIBU, CA
ZIP 90263
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Facility Phone Number: 310 506-4316

Facility Type: School/Student Health Service

Certificate Type: Microscopy

NPI Number: 1043867971

Taxonomy: 261QS1000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0876039
LAB Type	School/Student Health Service
Facility Name	PEPPERDINE UNIVERSITY STUDENT HEALTH CENTER
Street	24255 PACIFIC COAST HIGHWAY
City	MALIBU
State	CA
ZIP	90263
Phone	310 506-4316
CertificateType	3
CertificateEffectiveDate	10/13/2022
CertificateExpirationDate	10/12/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024