05D0947294 CLIA NUMBER - PRIMA PRIMARY MEDICAL ASSOC

Laboratory Demographics

  • CLIA Code: 05D0947294
  • Facility Name: PRIMA PRIMARY MEDICAL ASSOC
  • Facility Address: 9850 GENESEE AVE STE 355
    LA JOLLA, CA
    ZIP 92037
  • Facility Phone: 858 202-0011
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUCE COUNER MD
  • NPI Number: 1023002029
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0947294
LAB Type Physician Office
Facility Name PRIMA PRIMARY MEDICAL ASSOC
Street 9850 GENESEE AVE STE 355
City LA JOLLA
State CA
ZIP 92037
Phone 858 202-0011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2024
Certificate Expiration Date 6/11/2026
Facility Type Physician Office
Lab Director BRUCE COUNER MD

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