05D2029221 CLIA NUMBER - PRIMARY CARE CENTER OF NORTH COUNTY

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Laboratory Demographics

CLIA Number: 05D2029221

Facility Name: PRIMARY CARE CENTER OF NORTH COUNTY

Facility Address:
13525 MIDLAND RD. STE. F
POWAY, CA
ZIP 92064
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Facility Phone Number: 858 486-9100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1992096630

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2029221
LAB Type	Physician Office
Facility Name	PRIMARY CARE CENTER OF NORTH COUNTY
Street	13525 MIDLAND RD. STE. F
City	POWAY
State	CA
ZIP	92064
Phone	858 486-9100
CertificateType	4
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	Waiver

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