05D2204246 CLIA NUMBER - MARAVILLA

Laboratory Demographics

  • CLIA Code: 05D2204246
  • Facility Name: MARAVILLA
  • Facility Address: 5486 CALLE REAL
    GOLETA, CA
    ZIP 93111
  • Facility Phone: 805 967-1965
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: PAYAM PARVINCHIHA
  • NPI Number: 1477795144
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2204246
LAB Type Assisted Living Facility
Facility Name MARAVILLA
Street 5486 CALLE REAL
City GOLETA
State CA
ZIP 93111
Phone 805 967-1965
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Assisted Living Facility
Lab Director PAYAM PARVINCHIHA

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