05D0857907 CLIA NUMBER - SCRIPPS CLINIC DEL MAR

Laboratory Demographics

CLIA Number: 05D0857907

Facility Name: SCRIPPS CLINIC DEL MAR

Facility Address:
12395 EL CAMINO REAL
SAN DIEGO, CA
ZIP 92130
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Facility Phone Number: 858 554-9642

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124003280

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0857907
LAB Type	Physician Office
Facility Name	SCRIPPS CLINIC DEL MAR
Street	12395 EL CAMINO REAL
City	SAN DIEGO
State	CA
ZIP	92130
Phone	858 554-9642
CertificateType	4
CertificateEffectiveDate	2/20/2023
CertificateExpirationDate	2/19/2025
FacilityType	Waiver

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