05D2060632 CLIA NUMBER - SOUTH BAY INTERNAL MEDICINE AND FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 05D2060632
  • Facility Name: SOUTH BAY INTERNAL MEDICINE AND FAMILY PRACTICE
  • Facility Address: 374 H STREET, STE 202
    CHULA VISTA, CA
    ZIP 91910
  • Facility Phone: 619 426-4546
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NOLI A. CAVA
  • NPI Number: 1386914422
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 05D2060632
LAB Type Physician Office
Facility Name SOUTH BAY INTERNAL MEDICINE AND FAMILY PRACTICE
Street 374 H STREET, STE 202
City CHULA VISTA
State CA
ZIP 91910
Phone 619 426-4546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Physician Office
Lab Director NOLI A. CAVA

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