05D1036301 CLIA NUMBER - SAN DIEGO COUNTY SHERIFFS DEPT MED SVC

Laboratory Demographics

  • CLIA Code: 05D1036301
  • Facility Name: SAN DIEGO COUNTY SHERIFFS DEPT MED SVC
  • Facility Address: 5530 OVERLAND AVE STE 370
    SAN DIEGO, CA
    ZIP 92123
  • Facility Phone: 858 974-5971
  • Facility Type: Other - DETENTION FACILITY
  • Facility Type: Waiver
  • Lab Director: JON M. MONTGOMERY
  • NPI Number: 1508877002
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1036301
LAB Type Other - DETENTION FACILITY
Facility Name SAN DIEGO COUNTY SHERIFFS DEPT MED SVC
Street 5530 OVERLAND AVE STE 370
City SAN DIEGO
State CA
ZIP 92123
Phone 858 974-5971
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other - DETENTION FACILITY
Lab Director JON M. MONTGOMERY

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