05D2067385 CLIA NUMBER - IKIDNEY CARE CLINIC

Laboratory Demographics

  • CLIA Code: 05D2067385
  • Facility Name: IKIDNEY CARE CLINIC
  • Facility Address: 4440 EUCLID AVE
    SAN DIEGO, CA
    ZIP 92115
  • Facility Phone: 619 521-6812
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHARLES N. LE
  • NPI Number: 1639554041
  • Taxonomy: 207RN0300X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2067385
LAB Type Physician Office
Facility Name IKIDNEY CARE CLINIC
Street 4440 EUCLID AVE
City SAN DIEGO
State CA
ZIP 92115
Phone 619 521-6812
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/15/2023
Certificate Expiration Date 10/14/2025
Facility Type Physician Office
Lab Director CHARLES N. LE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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