05D1098125 CLIA NUMBER - AVALON PEDIATRICS INC

Laboratory Demographics

  • CLIA Code: 05D1098125
  • Facility Name: AVALON PEDIATRICS INC
  • Facility Address: 911 OAK PARK BLVD STE 107
    PISMO BEACH, CA
    ZIP 93449
  • Facility Phone: 805 474-8700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT S. EVANS
  • NPI Number: 1275538605
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D1098125
LAB Type Physician Office
Facility Name AVALON PEDIATRICS INC
Street 911 OAK PARK BLVD STE 107
City PISMO BEACH
State CA
ZIP 93449
Phone 805 474-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Physician Office
Lab Director ROBERT S. EVANS

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