05D0719140 CLIA NUMBER - GREGORY J WIENER MD

Laboratory Demographics

  • CLIA Code: 05D0719140
  • Facility Name: GREGORY J WIENER MD
  • Facility Address: 353 A CHURCH AVE
    CHULA VISTA, CA
    ZIP 91910
  • Facility Phone: 619 585-8883
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY J. WIENER
  • NPI Number: 1811099534
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0719140
LAB Type Physician Office
Facility Name GREGORY J WIENER MD
Street 353 A CHURCH AVE
City CHULA VISTA
State CA
ZIP 91910
Phone 619 585-8883
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 GREGORY J. WIENER

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