05D0996632 CLIA NUMBER - GLENN G SOPPE MD INC

Laboratory Demographics

CLIA Number: 05D0996632

Facility Name: GLENN G SOPPE MD INC

Facility Address:
345 SAXONY RD, SUITE 204
ENCINITAS, CA
ZIP 92024
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Facility Phone Number: 760 944-8402

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1730172461

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 05D0996632
LAB Type Physician Office
Facility Name GLENN G SOPPE MD INC
Street 345 SAXONY RD, SUITE 204
City ENCINITAS
State CA
ZIP 92024
Phone 760 944-8402
CertificateType 4
CertificateEffectiveDate 2/22/2024
CertificateExpirationDate 2/21/2026
FacilityType Waiver

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