05D0942984 CLIA NUMBER - DUNNUM OCCUPATIONAL CARE

Laboratory Demographics

  • CLIA Code: 05D0942984
  • Facility Name: DUNNUM OCCUPATIONAL CARE
  • Facility Address: 4510 EXECUTIVE DR, STE 107
    SAN DIEGO, CA
    ZIP 92121
  • Facility Phone: 858 457-4717
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUSSELL P. DUNNUM MD
  • NPI Number: 1457773699
  • Taxonomy: 2083X0100X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0942984
LAB Type Physician Office
Facility Name DUNNUM OCCUPATIONAL CARE
Street 4510 EXECUTIVE DR, STE 107
City SAN DIEGO
State CA
ZIP 92121
Phone 858 457-4717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2024
Certificate Expiration Date 3/18/2026
Facility Type Physician Office
Lab Director RUSSELL P. DUNNUM MD

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