05D2304920 CLIA NUMBER - BORREGO STAT CARE

Laboratory Demographics

  • CLIA Code: 05D2304920
  • Facility Name: BORREGO STAT CARE
  • Facility Address: 587 PALM CANYON DR SUITE 215
    BORREGO SPRINGS, CA
    ZIP 92004
  • Facility Phone: 760 284-1044
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: HOMAYOUN SIMAN
  • NPI Number: 1225890346
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D2304920
LAB Type Independent
Facility Name BORREGO STAT CARE
Street 587 PALM CANYON DR SUITE 215
City BORREGO SPRINGS
State CA
ZIP 92004
Phone 760 284-1044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Independent
Lab Director HOMAYOUN SIMAN

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