05D0917432 CLIA NUMBER - PROMETHEUS LABORATORIES, INC

Laboratory Demographics

  • CLIA Code: 05D0917432
  • Facility Name: PROMETHEUS LABORATORIES, INC
  • Facility Address: 9410 CARROLL PARK DR
    SAN DIEGO, CA
    ZIP 92121
  • Facility Phone: 858 587-4124
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. KENDAL J. JENSEN
  • NPI Number: 1073642641
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D0917432
LAB Type Independent
Facility Name PROMETHEUS LABORATORIES, INC
Street 9410 CARROLL PARK DR
City SAN DIEGO
State CA
ZIP 92121
Phone 858 587-4124
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Independent
Lab Director DR. KENDAL J. JENSEN

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