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05D2050858 CLIA NUMBER - CHILDREN'S PRIMARY CARE MEDICAL GROUP, INC.

Laboratory Demographics

CLIA Number: 05D2050858

Facility Name: CHILDREN'S PRIMARY CARE MEDICAL GROUP, INC.

Facility Address:
16918 DOVE CANYON RD., STE. 200
SAN DIEGO, CA
ZIP 92127
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Facility Phone Number: 858 636-4300

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1184788291

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 05D2050858
LAB Type Physician Office
Facility Name CHILDREN'S PRIMARY CARE MEDICAL GROUP, INC.
Street 16918 DOVE CANYON RD., STE. 200
City SAN DIEGO
State CA
ZIP 92127
Phone 858 636-4300
CertificateType 4
CertificateEffectiveDate 12/7/2022
CertificateExpirationDate 12/6/2024
FacilityType Waiver

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