05D0567227 CLIA NUMBER - DENNIS L COSTELLO MD

Laboratory Demographics

CLIA Number: 05D0567227

Facility Name: DENNIS L COSTELLO MD

Facility Address:
9850 GENESEE STE 430
LA JOLLA, CA
ZIP 92037
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Facility Phone Number: 858 450-3388

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679584551

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

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
CertificateType	4
CertificateEffectiveDate	9/26/2023
CertificateExpirationDate	9/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024