05D2290203 CLIA NUMBER - DR. SALLY PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D2290203
  • Facility Name: DR. SALLY PEDIATRICS
  • Facility Address: 3454 LOMA VISTA RD
    VENTURA, CA
    ZIP 93003
  • Facility Phone: 805 217-5644
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SALLY SMITH
  • NPI Number: 1558041590
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2290203
LAB Type Physician Office
Facility Name DR. SALLY PEDIATRICS
Street 3454 LOMA VISTA RD
City VENTURA
State CA
ZIP 93003
Phone 805 217-5644
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Physician Office
Lab Director SALLY SMITH

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