05D1019412 CLIA NUMBER - LAURA NORTON FAGERLUND MD

Laboratory Demographics

  • CLIA Code: 05D1019412
  • Facility Name: LAURA NORTON FAGERLUND MD
  • Facility Address: 1224 10TH STREET #200
    CORONADO, CA
    ZIP 92118
  • Facility Phone: 619 435-2234
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAURA N. FAGERLUND MD
  • NPI Number: 1033368741
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D1019412
LAB Type Physician Office
Facility Name LAURA NORTON FAGERLUND MD
Street 1224 10TH STREET #200
City CORONADO
State CA
ZIP 92118
Phone 619 435-2234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director LAURA N. FAGERLUND MD

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