05D0913049 CLIA NUMBER - CENTRAL COAST PEDIATRICS INC

Laboratory Demographics

  • CLIA Code: 05D0913049
  • Facility Name: CENTRAL COAST PEDIATRICS INC
  • Facility Address: 1320 LAS TABLAS RD, STE D
    TEMPLETON, CA
    ZIP 93465
  • Facility Phone: 805 434-3796
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD J. MACIAS
  • NPI Number: 1083869804
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0913049
LAB Type Physician Office
Facility Name CENTRAL COAST PEDIATRICS INC
Street 1320 LAS TABLAS RD, STE D
City TEMPLETON
State CA
ZIP 93465
Phone 805 434-3796
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Physician Office
Lab Director DR. RICHARD J. MACIAS

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