05D0570328 CLIA NUMBER - SAN DIEGO PRIMARY CARE MEDICAL GROUP,

Laboratory Demographics

CLIA Number: 05D0570328

Facility Name: SAN DIEGO PRIMARY CARE MEDICAL GROUP,

Facility Address:
3737 MORAGA AVE # B -408
SAN DIEGO, CA
ZIP 92117
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Facility Phone Number: (619) 292-8885

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1932257193

Taxonomy: 207QA0505X - Family Medicine
Definition to come.

CLIA Record

Field Name Field Value
CLIA Number 05D0570328
LAB Type PHYSICIAN OFFICE
Facility Name SAN DIEGO PRIMARY CARE MEDICAL GROUP,
Street 3737 MORAGA AVE # B -408
City SAN DIEGO
State CA
ZIP 92117
Phone (619) 292-8885

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This page was last updated on: 1/7/2022