05D2294659 CLIA NUMBER - EVERSIDE HEALTH CHULA VISTA

Laboratory Demographics

  • CLIA Code: 05D2294659
  • Facility Name: EVERSIDE HEALTH CHULA VISTA
  • Facility Address: 480 4TH AVENUE SUITE 207
    CHULA VISTA, CA
    ZIP 91910
  • Facility Phone: 619 866-6848
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN LANDSBERG
  • NPI Number: 1245016906
  • Taxonomy: 2083P0500X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2294659
LAB Type Physician Office
Facility Name EVERSIDE HEALTH CHULA VISTA
Street 480 4TH AVENUE SUITE 207
City CHULA VISTA
State CA
ZIP 91910
Phone 619 866-6848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Physician Office
Lab Director JOHN LANDSBERG

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