05D0570170 CLIA NUMBER - GREEN GAIDRY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D0570170
  • Facility Name: GREEN GAIDRY MEDICAL CLINIC
  • Facility Address: 1101 FELSPAR STREET
    SAN DIEGO, CA
    ZIP 92109
  • Facility Phone: 858 483-1720
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BILLIE E. GREEN,MD

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0570170
LAB Type Physician Office
Facility Name GREEN GAIDRY MEDICAL CLINIC
Street 1101 FELSPAR STREET
City SAN DIEGO
State CA
ZIP 92109
Phone 858 483-1720
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/21/2023
Certificate Expiration Date 8/20/2025
Facility Type Physician Office
Lab Director BILLIE E. GREEN,MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025