05D2295755 CLIA NUMBER - PACIFIC BEACH HEALTH LLC

Laboratory Demographics

  • CLIA Code: 05D2295755
  • Facility Name: PACIFIC BEACH HEALTH LLC
  • Facility Address: 2108 GARNET AVE UNIT A
    SAN DIEGO, CA
    ZIP 92109
  • Facility Phone: 858 922-9359
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JOHN M. ALLEN
  • NPI Number: 1932435831
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 05D2295755
LAB Type Comp. Outpatient Rehab Facility
Facility Name PACIFIC BEACH HEALTH LLC
Street 2108 GARNET AVE UNIT A
City SAN DIEGO
State CA
ZIP 92109
Phone 858 922-9359
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Comp. Outpatient Rehab Facility
Lab Director JOHN M. ALLEN

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