05D2020581 CLIA NUMBER - RICHARD G FRIEDMAN MD & JERROLD GLASSMAN MD

Laboratory Demographics

  • CLIA Code: 05D2020581
  • Facility Name: RICHARD G FRIEDMAN MD & JERROLD GLASSMAN MD
  • Facility Address: 4060 FOUTH AVE DTE 650
    SAN DIEGO, CA
    ZIP 92103
  • Facility Phone: 619 819-7222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD G. FRIEDMAN
  • NPI Number: 1881789196
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2020581
LAB Type Physician Office
Facility Name RICHARD G FRIEDMAN MD & JERROLD GLASSMAN MD
Street 4060 FOUTH AVE DTE 650
City SAN DIEGO
State CA
ZIP 92103
Phone 619 819-7222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Physician Office
Lab Director RICHARD G. FRIEDMAN

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