05D2040827 CLIA NUMBER - GEOFFREY P GROOM MD

Laboratory Demographics

  • CLIA Code: 05D2040827
  • Facility Name: GEOFFREY P GROOM MD
  • Facility Address: 860 KUHN DR SUITE 105
    CHULA VISTA, CA
    ZIP 91914
  • Facility Phone: 619 656-6311
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEOFFREY P. GROOM
  • NPI Number: 1558409334
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2040827
LAB Type Physician Office
Facility Name GEOFFREY P GROOM MD
Street 860 KUHN DR SUITE 105
City CHULA VISTA
State CA
ZIP 91914
Phone 619 656-6311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Physician Office
Lab Director GEOFFREY P. GROOM

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