05D2010874 CLIA NUMBER - THOMAS HARRIS MD

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Laboratory Demographics

CLIA Number: 05D2010874

Facility Name: THOMAS HARRIS MD

Facility Address:
450 4TH AVE STE 201
CHULA VISTA, CA
ZIP 91910
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Facility Phone Number: 858 874-3444

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316056492

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D2010874
LAB Type	Physician Office
Facility Name	THOMAS HARRIS MD
Street	450 4TH AVE STE 201
City	CHULA VISTA
State	CA
ZIP	91910
Phone	858 874-3444
CertificateType	4
CertificateEffectiveDate	8/6/2022
CertificateExpirationDate	8/5/2024
FacilityType	Waiver

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