05D0951356 CLIA NUMBER - COASTAL HEART MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0951356
  • Facility Name: COASTAL HEART MEDICAL GROUP INC
  • Facility Address: 2621 S BRISTOL STREET SUITE 108
    SANTA ANA, CA
    ZIP 92704
  • Facility Phone: 714 754-1684
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANIL V. SHAH MD
  • NPI Number: 1881612828
  • Taxonomy: 207RC0000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0951356
LAB Type Physician Office
Facility Name COASTAL HEART MEDICAL GROUP INC
Street 2621 S BRISTOL STREET SUITE 108
City SANTA ANA
State CA
ZIP 92704
Phone 714 754-1684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Physician Office
Lab Director ANIL V. SHAH 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