05D0914897 CLIA NUMBER - VALLEY CENTER PEDIATRICS

Laboratory Demographics

CLIA Number: 05D0914897

Facility Name: VALLEY CENTER PEDIATRICS

Facility Address:
28714 VALLEY CENTER ROAD #L
VALLEY CENTER, CA
ZIP 92082
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Facility Phone Number: 617 749-7770

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548317100

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name	Field Value
CLIA Number	05D0914897
LAB Type	Physician Office
Facility Name	VALLEY CENTER PEDIATRICS
Street	28714 VALLEY CENTER ROAD #L
City	VALLEY CENTER
State	CA
ZIP	92082
Phone	617 749-7770
CertificateType	4
CertificateEffectiveDate	5/14/2024
CertificateExpirationDate	5/13/2026
FacilityType	Waiver

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