05D2214583 CLIA NUMBER - BEACH FAMILY DOCTORS

Laboratory Demographics

CLIA Number: 05D2214583

Facility Name: BEACH FAMILY DOCTORS

Facility Address:
2001 WESTCLIFF DR SUITE 200
NEWPORT BEACH, CA
ZIP 92660
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Facility Phone Number: 714 845-5900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1538110465

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2214583
LAB Type	Physician Office
Facility Name	BEACH FAMILY DOCTORS
Street	2001 WESTCLIFF DR SUITE 200
City	NEWPORT BEACH
State	CA
ZIP	92660
Phone	714 845-5900
CertificateType	4
CertificateEffectiveDate	2/23/2023
CertificateExpirationDate	2/22/2025
FacilityType	Waiver

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