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05D0994484 CLIA NUMBER - COASTAL KIDS, A PROFESSIONAL MEDICAL CORP

Laboratory Demographics

CLIA Number: 05D0994484

Facility Name: COASTAL KIDS, A PROFESSIONAL MEDICAL CORP

Facility Address:
2071 SAN JOAQUIN HILLS RD
NEWPORT BEACH, CA
ZIP 92660
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Facility Phone Number: 949 759-1720

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1740311737

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 05D0994484
LAB Type Physician Office
Facility Name COASTAL KIDS, A PROFESSIONAL MEDICAL CORP
Street 2071 SAN JOAQUIN HILLS RD
City NEWPORT BEACH
State CA
ZIP 92660
Phone 949 759-1720
CertificateType 4
CertificateEffectiveDate 7/10/2023
CertificateExpirationDate 7/9/2025
FacilityType Waiver

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