05D2155060 CLIA NUMBER - PACIFIC PACE, LLC

Laboratory Demographics

CLIA Code: 05D2155060
Facility Name: PACIFIC PACE, LLC
Facility Address: 50 ALESSANDRO PLACE STE 100
PASADENA, CA
ZIP 91105
Facility Phone: 626 314-1411
Facility Type: Other - PROG ALL INCLUSIVE CARE
Facility Type: Waiver
Lab Director: COLIN L. ROBINSON
NPI Number: 1194202697
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	05D2155060
LAB Type	Other - PROG ALL INCLUSIVE CARE
Facility Name	PACIFIC PACE, LLC
Street	50 ALESSANDRO PLACE STE 100
City	PASADENA
State	CA
ZIP	91105
Phone	626 314-1411
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/24/2024
Certificate Expiration Date	9/23/2026
Facility Type	Other - PROG ALL INCLUSIVE CARE
Lab Director	COLIN L. ROBINSON

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