05D0599579 CLIA NUMBER - AXIS COMMUNITY HEALTH

Laboratory Demographics

CLIA Number: 05D0599579

Facility Name: AXIS COMMUNITY HEALTH

Facility Address:
5925 W LAS POSITAS BLVD, STE 100
PLEASANTON, CA
ZIP 94588
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Facility Phone Number: 925 462-1755

Facility Type: Other - FQHC

Certificate Type: Microscopy

NPI Number: 1124461397

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0599579
LAB Type	Other - FQHC
Facility Name	AXIS COMMUNITY HEALTH
Street	5925 W LAS POSITAS BLVD, STE 100
City	PLEASANTON
State	CA
ZIP	94588
Phone	925 462-1755
CertificateType	3
CertificateEffectiveDate	1/5/2023
CertificateExpirationDate	1/4/2025
FacilityType	PPMP

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