05D1093807 CLIA NUMBER - CRYSTAL COVE CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D1093807
  • Facility Name: CRYSTAL COVE CARE CENTER
  • Facility Address: 1445 SUPERIOR AVE
    NEWPORT BEACH, CA
    ZIP 92663
  • Facility Phone: 949 515-3930
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: WERNHER OVALLE
  • NPI Number: 1720273576
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D1093807
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CRYSTAL COVE CARE CENTER
Street 1445 SUPERIOR AVE
City NEWPORT BEACH
State CA
ZIP 92663
Phone 949 515-3930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director WERNHER OVALLE

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This page was last updated on: 9/29/2025