05D2025579 CLIA NUMBER - COASTAL KIDS CALIFORNIA PEDIATRIC CARE

Laboratory Demographics

  • CLIA Code: 05D2025579
  • Facility Name: COASTAL KIDS CALIFORNIA PEDIATRIC CARE
  • Facility Address: 1920 N GAREY AVE
    POMONA, CA
    ZIP 91767
  • Facility Phone: 909 622-1235
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAPNA PATEL
  • NPI Number: 1700171105
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2025579
LAB Type Physician Office
Facility Name COASTAL KIDS CALIFORNIA PEDIATRIC CARE
Street 1920 N GAREY AVE
City POMONA
State CA
ZIP 91767
Phone 909 622-1235
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2025
Certificate Expiration Date 6/12/2027
Facility Type Physician Office
Lab Director SAPNA PATEL

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This page was last updated on: 6/4/2025