05D0985882 CLIA NUMBER - CASA PACIFICA ADULT DAY HLTH CARE CTR

Laboratory Demographics

CLIA Number: 05D0985882

Facility Name: CASA PACIFICA ADULT DAY HLTH CARE CTR

Facility Address:
1424 30TH ST STE C
SAN DIEGO, CA
ZIP 92154
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Facility Phone Number: 619 424-8181

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1609920305

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0985882
LAB Type	Other
Facility Name	CASA PACIFICA ADULT DAY HLTH CARE CTR
Street	1424 30TH ST STE C
City	SAN DIEGO
State	CA
ZIP	92154
Phone	619 424-8181
CertificateType	4
CertificateEffectiveDate	5/1/2023
CertificateExpirationDate	4/30/2025
FacilityType	Waiver

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