05D2042904 CLIA NUMBER - ADVANTAGE HEALTH SYSTEMS

Laboratory Demographics

  • CLIA Code: 05D2042904
  • Facility Name: ADVANTAGE HEALTH SYSTEMS
  • Facility Address: 9663 TIERRA GRANDE ST STE 204
    SAN DIEGO, CA
    ZIP 92126
  • Facility Phone: 858 547-0077
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MARK A. SHAFFER
  • NPI Number: 1235414343
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2042904
LAB Type Hospice
Facility Name ADVANTAGE HEALTH SYSTEMS
Street 9663 TIERRA GRANDE ST STE 204
City SAN DIEGO
State CA
ZIP 92126
Phone 858 547-0077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Hospice
Lab Director MARK A. SHAFFER

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