05D1036645 CLIA NUMBER - OCCUPATIONAL HEALTH SERVICES CLINIC

Laboratory Demographics

CLIA Number: 05D1036645

Facility Name: OCCUPATIONAL HEALTH SERVICES CLINIC

Facility Address:
10777 SCIENCE CENTER DR
SAN DIEGO, CA
ZIP 92121
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Facility Phone Number: 858 638-3769

Facility Type: Other - OCCUPATIONAL HEALTH CLINI

Certificate Type: Waiver

NPI Number: 1124282793

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1036645
LAB Type	Other - OCCUPATIONAL HEALTH CLINI
Facility Name	OCCUPATIONAL HEALTH SERVICES CLINIC
Street	10777 SCIENCE CENTER DR
City	SAN DIEGO
State	CA
ZIP	92121
Phone	858 638-3769
CertificateType	4
CertificateEffectiveDate	2/1/2024
CertificateExpirationDate	1/31/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024