05D0971701 CLIA NUMBER - DEL MAR SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D0971701
  • Facility Name: DEL MAR SURGERY CENTER
  • Facility Address: 11425 EL CAMINO REAL STE A
    SAN DIEGO, CA
    ZIP 92130
  • Facility Phone: 858 794-6364
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: L M. KETTEL MD
  • NPI Number: 1336508621
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0971701
LAB Type Ambulatory Surgery Center
Facility Name DEL MAR SURGERY CENTER
Street 11425 EL CAMINO REAL STE A
City SAN DIEGO
State CA
ZIP 92130
Phone 858 794-6364
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2024
Certificate Expiration Date 3/19/2026
Facility Type Ambulatory Surgery Center
Lab Director L M. KETTEL MD

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