05D2014452 CLIA NUMBER - BLAKE R THOMPSON, MD INC

Laboratory Demographics

  • CLIA Code: 05D2014452
  • Facility Name: BLAKE R THOMPSON, MD INC
  • Facility Address: 9040 FRIARS RD STE 400
    SAN DIEGO, CA
    ZIP 92108
  • Facility Phone: 619 284-6377
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLAKE R. THOMPSON
  • NPI Number: 1043308471
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 05D2014452
LAB Type Physician Office
Facility Name BLAKE R THOMPSON, MD INC
Street 9040 FRIARS RD STE 400
City SAN DIEGO
State CA
ZIP 92108
Phone 619 284-6377
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Physician Office
Lab Director BLAKE R. THOMPSON

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