05D1075344 CLIA NUMBER - JEAN RIZKALLAH, MD INC

Laboratory Demographics

  • CLIA Code: 05D1075344
  • Facility Name: JEAN RIZKALLAH, MD INC
  • Facility Address: 450 FOURTH AVE STE 408
    CHULA VISTA, CA
    ZIP 91910
  • Facility Phone: 619 691-1990
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEAN A. RIZKALLAH MD
  • NPI Number: 1003800368
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1075344
LAB Type Physician Office
Facility Name JEAN RIZKALLAH, MD INC
Street 450 FOURTH AVE STE 408
City CHULA VISTA
State CA
ZIP 91910
Phone 619 691-1990
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 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Physician Office
Lab Director JEAN A. RIZKALLAH MD

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