05D2055590 CLIA NUMBER - SAN DIEGO SKIN INC

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Laboratory Demographics

CLIA Number: 05D2055590

Facility Name: SAN DIEGO SKIN INC

Facility Address:
4150 REGENTS PARK ROW STE 300
LA JOLLA, CA
ZIP 92037
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Facility Phone Number: (858) 909-9000

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1972831998

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2055590
LAB Type	AMBULATORY SURGERY CENTER
Facility Name	SAN DIEGO SKIN INC
Street	4150 REGENTS PARK ROW STE 300
City	LA JOLLA
State	CA
ZIP	92037
Phone	(858) 909-9000

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This page was last updated on: 5/11/2023