05D0569878 CLIA NUMBER - SAN DIEGO FAMILY CARE DBA

Laboratory Demographics

CLIA Number: 05D0569878

Facility Name: SAN DIEGO FAMILY CARE DBA

Facility Address:
4290 POLK AVENUE
SAN DIEGO, CA
ZIP 92105
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Facility Phone Number: (619) 563-0507

Facility Type: COMMUNITY CLINIC

Certificate Type: Accreditation

NPI Number: 1962483040

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0569878
LAB Type	COMMUNITY CLINIC
Facility Name	SAN DIEGO FAMILY CARE DBA
Street	4290 POLK AVENUE
City	SAN DIEGO
State	CA
ZIP	92105
Phone	(619) 563-0507

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This page was last updated on: 5/11/2023