05D1013664 CLIA NUMBER - UCSD CENTER FOR INNOVATIVE THERAPY

Laboratory Demographics

CLIA Code: 05D1013664
Facility Name: UCSD CENTER FOR INNOVATIVE THERAPY
Facility Address: 9500 GILMAN DRIVE
LA JOLLA, CA
ZIP 92093
Facility Phone: 858 657-7048
Facility Type: Hospital
Facility Type: Waiver
Lab Director: ARTHUR F. KAVANAUGH MD
NPI Number: 1730611864
Taxonomy: 390200000X - Student in an Organized Health Care Education/Training Program

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CLIA Record

Field Name	Field Value
CLIA Number	05D1013664
LAB Type	Hospital
Facility Name	UCSD CENTER FOR INNOVATIVE THERAPY
Street	9500 GILMAN DRIVE
City	LA JOLLA
State	CA
ZIP	92093
Phone	858 657-7048
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	6/13/2023
Certificate Expiration Date	6/12/2025
Facility Type	Hospital
Lab Director	ARTHUR F. KAVANAUGH MD

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This page was last updated on: 3/20/2025