05D0689194 CLIA NUMBER - PHILIP D SZOLD MD, INC / LA MESA PED MED GROUP

Laboratory Demographics

CLIA Number: 05D0689194

Facility Name: PHILIP D SZOLD MD, INC / LA MESA PED MED GROUP

Facility Address:
8881 FLETCHER PKWY, STE 200
LA MESA, CA
ZIP 91942
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Facility Phone Number: 619 464-6434

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1427268747

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0689194
LAB Type	Physician Office
Facility Name	PHILIP D SZOLD MD, INC / LA MESA PED MED GROUP
Street	8881 FLETCHER PKWY, STE 200
City	LA MESA
State	CA
ZIP	91942
Phone	619 464-6434
CertificateType	4
CertificateEffectiveDate	2/21/2023
CertificateExpirationDate	2/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024