05D2099529 CLIA NUMBER - AIDS HEALTHCARE FOUNDATION

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Laboratory Demographics

CLIA Number: 05D2099529

Facility Name: AIDS HEALTHCARE FOUNDATION

Facility Address:
3580 5TH AVE SUITE 250 MAIN SITE
SAN DIEGO, CA
ZIP 92103
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Facility Phone Number: 619 516-8931

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437561784

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	05D2099529
LAB Type	Physician Office
Facility Name	AIDS HEALTHCARE FOUNDATION
Street	3580 5TH AVE SUITE 250 MAIN SITE
City	SAN DIEGO
State	CA
ZIP	92103
Phone	619 516-8931
CertificateType	4
CertificateEffectiveDate	10/24/2022
CertificateExpirationDate	10/23/2024
FacilityType	Waiver

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