05D0570833 CLIA NUMBER - GENESEE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0570833
  • Facility Name: GENESEE MEDICAL GROUP
  • Facility Address: 3880 MURPHY CANYON RD STE 120
    SAN DIEGO, CA
    ZIP 92123
  • Facility Phone: 858 268-1111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY H. DYSART
  • NPI Number: 1043480320
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0570833
LAB Type Physician Office
Facility Name GENESEE MEDICAL GROUP
Street 3880 MURPHY CANYON RD STE 120
City SAN DIEGO
State CA
ZIP 92123
Phone 858 268-1111
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 JEFFREY H. DYSART

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