05D2283345 CLIA NUMBER - VELASCO MEDICAL CORP

Laboratory Demographics

  • CLIA Code: 05D2283345
  • Facility Name: VELASCO MEDICAL CORP
  • Facility Address: 1741 EASTLAKE PKWY SUITE 102
    CHULA VISTA, CA
    ZIP 91915
  • Facility Phone: 619 775-8017
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICTOR R. VELASCO ANDRADE
  • NPI Number: 1073277539
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2283345
LAB Type Physician Office
Facility Name VELASCO MEDICAL CORP
Street 1741 EASTLAKE PKWY SUITE 102
City CHULA VISTA
State CA
ZIP 91915
Phone 619 775-8017
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Physician Office
Lab Director VICTOR R. VELASCO ANDRADE

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