05D1065419 CLIA NUMBER - SCRIPPS CLINIC MEDICAL LABORATORIES- MISSION VALLEY

Laboratory Demographics

CLIA Number: 05D1065419

Facility Name: SCRIPPS CLINIC MEDICAL LABORATORIES- MISSION VALLEY

Facility Address:
7425 MISSION VALLEY ROAD STE 202
SAN DIEGO, CA
ZIP 92108
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Facility Phone Number: 858 554-9642

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1457336273

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1065419
LAB Type	Physician Office
Facility Name	SCRIPPS CLINIC MEDICAL LABORATORIES- MISSION VALLEY
Street	7425 MISSION VALLEY ROAD STE 202
City	SAN DIEGO
State	CA
ZIP	92108
Phone	858 554-9642
CertificateType	4
CertificateEffectiveDate	1/6/2024
CertificateExpirationDate	1/5/2026
FacilityType	Waiver

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