05D0570619 CLIA NUMBER - KUMARA PRATHIPATI

Laboratory Demographics

  • CLIA Code: 05D0570619
  • Facility Name: KUMARA PRATHIPATI
  • Facility Address: 4276 54TH PL
    SAN DIEGO, CA
    ZIP 92115
  • Facility Phone: 619 286-3222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KUMARA S. PRATHIPATI
  • NPI Number: 1538267778
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0570619
LAB Type Physician Office
Facility Name KUMARA PRATHIPATI
Street 4276 54TH PL
City SAN DIEGO
State CA
ZIP 92115
Phone 619 286-3222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director KUMARA S. PRATHIPATI

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