05D2295195 CLIA NUMBER - SGF SOCAL, LLC

Laboratory Demographics

CLIA Number: 05D2295195

Facility Name: SGF SOCAL, LLC

Facility Address:
462 STEVENS AVE SUITE 206
SOLANA BEACH, CA
ZIP 92075
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Facility Phone Number: 301 545-1210

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1063197648

Taxonomy: 207VE0102X - Obstetrics & Gynecology
An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.

CLIA Record

Field Name	Field Value
CLIA Number	05D2295195
LAB Type	Physician Office
Facility Name	SGF SOCAL, LLC
Street	462 STEVENS AVE SUITE 206
City	SOLANA BEACH
State	CA
ZIP	92075
Phone	301 545-1210
CertificateType	4
CertificateEffectiveDate	12/6/2023
CertificateExpirationDate	12/5/2025
FacilityType	Waiver

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