05D1015720 CLIA NUMBER - RICK T CHAC, MD INC

Laboratory Demographics

  • CLIA Code: 05D1015720
  • Facility Name: RICK T CHAC, MD INC
  • Facility Address: 660 OLD TELEGRAPH CANYON RD
    CHULA VISTA, CA
    ZIP 91910
  • Facility Phone: 619 482-2400
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICK T. CHAC, MD
  • NPI Number: 1538347760
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D1015720
LAB Type Physician Office
Facility Name RICK T CHAC, MD INC
Street 660 OLD TELEGRAPH CANYON RD
City CHULA VISTA
State CA
ZIP 91910
Phone 619 482-2400
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Physician Office
Lab Director RICK T. CHAC, MD

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