05D2104041 CLIA NUMBER - COAST PEDIATRICS CARMEL VALLEY

Laboratory Demographics

CLIA Number: 05D2104041

Facility Name: COAST PEDIATRICS CARMEL VALLEY

Facility Address:
5965 VILLAGE WAY STE 201
SAN DIEGO, CA
ZIP 92130
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Facility Phone Number: 858 755-7337

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1427434679

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	05D2104041
LAB Type	Physician Office
Facility Name	COAST PEDIATRICS CARMEL VALLEY
Street	5965 VILLAGE WAY STE 201
City	SAN DIEGO
State	CA
ZIP	92130
Phone	858 755-7337
CertificateType	4
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024