05D2080737 CLIA NUMBER - SOMAGEN HEALTHCARE III INC AFC URGENT CARE OF SAN DIEGO

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Laboratory Demographics

CLIA Number: 05D2080737

Facility Name: SOMAGEN HEALTHCARE III INC AFC URGENT CARE OF SAN DIEGO

Facility Address:
5671 BALBOA AVE
SAN DIEGO, CA
ZIP 92111
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Facility Phone Number: 858 800-2880

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558788620

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2080737
LAB Type	Physician Office
Facility Name	SOMAGEN HEALTHCARE III INC AFC URGENT CARE OF SAN DIEGO
Street	5671 BALBOA AVE
City	SAN DIEGO
State	CA
ZIP	92111
Phone	858 800-2880
CertificateType	4
CertificateEffectiveDate	7/14/2022
CertificateExpirationDate	7/13/2024
FacilityType	Waiver

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