05D0855576 CLIA NUMBER - LA JOLLA VILLAGE FAMILY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0855576
  • Facility Name: LA JOLLA VILLAGE FAMILY MEDICAL GROUP
  • Facility Address: 8950 VILLA LA JOLLA DR, STE C129
    LA JOLLA, CA
    ZIP 92037
  • Facility Phone: 858 450-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL MICHAELS
  • NPI Number: 1316244619
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0855576
LAB Type Physician Office
Facility Name LA JOLLA VILLAGE FAMILY MEDICAL GROUP
Street 8950 VILLA LA JOLLA DR, STE C129
City LA JOLLA
State CA
ZIP 92037
Phone 858 450-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director DANIEL MICHAELS

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