05D2009927 CLIA NUMBER - CALIFORNIA CENTER FOR REPRODUCTIVE MEDICINE

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Laboratory Demographics

CLIA Number: 05D2009927

Facility Name: CALIFORNIA CENTER FOR REPRODUCTIVE MEDICINE

Facility Address:
477 EL CAMINO REAL, STE C310
ENCINITAS, CA
ZIP 92024
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Facility Phone Number: 760 274-2000

Facility Type: Practitioner Other

Certificate Type: Accreditation

NPI Number: 1548533532

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	05D2009927
LAB Type	Practitioner Other
Facility Name	CALIFORNIA CENTER FOR REPRODUCTIVE MEDICINE
Street	477 EL CAMINO REAL, STE C310
City	ENCINITAS
State	CA
ZIP	92024
Phone	760 274-2000
CertificateType	1
CertificateEffectiveDate	11/8/2023
CertificateExpirationDate	11/7/2025
FacilityType	Accreditation

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