05D1000613 CLIA NUMBER - VI AT LA JOLLA VILLAGE ,

Laboratory Demographics

  • CLIA Code: 05D1000613
  • Facility Name: VI AT LA JOLLA VILLAGE ,
  • Facility Address: 8515 COSTA VERDE BLVD
    SAN DIEGO, CA
    ZIP 92122
  • Facility Phone: 858 646-3400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RAWI TAIB, DO
  • NPI Number: 1972574507
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1000613
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name VI AT LA JOLLA VILLAGE ,
Street 8515 COSTA VERDE BLVD
City SAN DIEGO
State CA
ZIP 92122
Phone 858 646-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RAWI TAIB, DO

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