05D2204846 CLIA NUMBER - REFRESH RECOVERY

Laboratory Demographics

  • CLIA Code: 05D2204846
  • Facility Name: REFRESH RECOVERY
  • Facility Address: 4141 JUTLAND DRIVE SUITE 110
    SAN DIEGO, CA
    ZIP 92114
  • Facility Phone: 619 455-1318
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: RAJAGOPAL KEERTHY SUNDER
  • NPI Number: 1891320099
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2204846
LAB Type Comp. Outpatient Rehab Facility
Facility Name REFRESH RECOVERY
Street 4141 JUTLAND DRIVE SUITE 110
City SAN DIEGO
State CA
ZIP 92114
Phone 619 455-1318
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director RAJAGOPAL KEERTHY SUNDER

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