05D2019569 CLIA NUMBER - MUSHRIK KAISEY, MD

Laboratory Demographics

  • CLIA Code: 05D2019569
  • Facility Name: MUSHRIK KAISEY, MD
  • Facility Address: 340 4TH AVE STE 9
    CHULA VISTA, CA
    ZIP 91910
  • Facility Phone: 619 426-9731
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MUSHRIK KAISEY
  • NPI Number: 1386654010
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2019569
LAB Type Physician Office
Facility Name MUSHRIK KAISEY, MD
Street 340 4TH AVE STE 9
City CHULA VISTA
State CA
ZIP 91910
Phone 619 426-9731
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type Physician Office
Lab Director MUSHRIK KAISEY

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