05D2040704 CLIA NUMBER - ST. PAUL'S PACE AKALOA

Laboratory Demographics

  • CLIA Code: 05D2040704
  • Facility Name: ST. PAUL'S PACE AKALOA
  • Facility Address: 630 L STREET
    CHULA VISTA, CA
    ZIP 91911
  • Facility Phone: 619 677-3800
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JAIME STULL
  • NPI Number: 1720271448
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2040704
LAB Type Community Clinic
Facility Name ST. PAUL'S PACE AKALOA
Street 630 L STREET
City CHULA VISTA
State CA
ZIP 91911
Phone 619 677-3800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2024
Certificate Expiration Date 5/7/2026
Facility Type Community Clinic
Lab Director JAIME STULL

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