05D2112658 CLIA NUMBER - NORTH COUNTY DENTAL SURGERY

Laboratory Demographics

  • CLIA Code: 05D2112658
  • Facility Name: NORTH COUNTY DENTAL SURGERY
  • Facility Address: 838 NORDAHL RD STE 125
    SAN MARCOS, CA
    ZIP 92069
  • Facility Phone: 760 294-6208
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: LEWIS COLEMAN DM
  • NPI Number: 1023314580
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2112658
LAB Type Ambulatory Surgery Center
Facility Name NORTH COUNTY DENTAL SURGERY
Street 838 NORDAHL RD STE 125
City SAN MARCOS
State CA
ZIP 92069
Phone 760 294-6208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Ambulatory Surgery Center
Lab Director LEWIS COLEMAN DM

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