05D2267577 CLIA NUMBER - COAST PEDIATRICS 4S

Laboratory Demographics

  • CLIA Code: 05D2267577
  • Facility Name: COAST PEDIATRICS 4S
  • Facility Address: 17085 CAMINO SAN BERNARDO SUITE 100
    SAN DIEGO, CA
    ZIP 92127
  • Facility Phone: 858 794-7337
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORI B. TAYLOR
  • NPI Number: 1720747389
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2267577
LAB Type Physician Office
Facility Name COAST PEDIATRICS 4S
Street 17085 CAMINO SAN BERNARDO SUITE 100
City SAN DIEGO
State CA
ZIP 92127
Phone 858 794-7337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Physician Office
Lab Director LORI B. TAYLOR

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