05D0996632 CLIA NUMBER - GLENN G SOPPE MD INC

Laboratory Demographics

  • CLIA Code: 05D0996632
  • Facility Name: GLENN G SOPPE MD INC
  • Facility Address: 345 SAXONY RD, SUITE 204
    ENCINITAS, CA
    ZIP 92024
  • Facility Phone: 760 944-8402
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GLENN G. SOPPE MD
  • NPI Number: 1730172461
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Physician Office
Lab Director GLENN G. SOPPE MD

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