05D2194733 CLIA NUMBER - DANIEL COSGROVE MD

Laboratory Demographics

  • CLIA Code: 05D2194733
  • Facility Name: DANIEL COSGROVE MD
  • Facility Address: 45-200 CLUB DRIVE SUITE B
    INDIAN WELLS, CA
    ZIP 92210
  • Facility Phone: 760 799-8499
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL S. COSGROVE
  • NPI Number: 1235257429
  • Taxonomy: 2083P0901X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2194733
LAB Type Physician Office
Facility Name DANIEL COSGROVE MD
Street 45-200 CLUB DRIVE SUITE B
City INDIAN WELLS
State CA
ZIP 92210
Phone 760 799-8499
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director DANIEL S. COSGROVE

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