05D0567227 CLIA NUMBER - DENNIS L COSTELLO MD

Laboratory Demographics

  • CLIA Code: 05D0567227
  • Facility Name: DENNIS L COSTELLO MD
  • Facility Address: 9850 GENESEE STE 430
    LA JOLLA, CA
    ZIP 92037
  • Facility Phone: 858 450-3388
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DENNIS L. COSTELLO
  • NPI Number: 1679584551
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0567227
LAB Type Physician Office
Facility Name DENNIS L COSTELLO MD
Street 9850 GENESEE STE 430
City LA JOLLA
State CA
ZIP 92037
Phone 858 450-3388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2025
Certificate Expiration Date 9/25/2027
Facility Type Physician Office
Lab Director DENNIS L. COSTELLO

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