05D0891063 CLIA NUMBER - DOCTORS OFFICE & WALK-IN CLINIC

Laboratory Demographics

CLIA Number: 05D0891063

Facility Name: DOCTORS OFFICE & WALK-IN CLINIC

Facility Address:
3863 CLAIREMONT DRIVE
SAN DIEGO, CA
ZIP 92117
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Facility Phone Number: 858 483-5570

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1932257193

Taxonomy: 207QA0505X - Family Medicine
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

CLIA Record

Field Name	Field Value
CLIA Number	05D0891063
LAB Type	Physician Office
Facility Name	DOCTORS OFFICE & WALK-IN CLINIC
Street	3863 CLAIREMONT DRIVE
City	SAN DIEGO
State	CA
ZIP	92117
Phone	858 483-5570
CertificateType	4
CertificateEffectiveDate	8/30/2022
CertificateExpirationDate	8/29/2024
FacilityType	Waiver

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