05D1012482 CLIA NUMBER - SDOSC LP

Laboratory Demographics

  • CLIA Code: 05D1012482
  • Facility Name: SDOSC LP
  • Facility Address: 3939 RUFFIN ROAD, SUITE 101
    SAN DIEGO, CA
    ZIP 92123
  • Facility Phone: 619 299-9530
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER H. GLAZENER
  • NPI Number: 1942261599
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1012482
LAB Type Ambulatory Surgery Center
Facility Name SDOSC LP
Street 3939 RUFFIN ROAD, SUITE 101
City SAN DIEGO
State CA
ZIP 92123
Phone 619 299-9530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Ambulatory Surgery Center
Lab Director CHRISTOPHER H. GLAZENER

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