05D0600577 CLIA NUMBER - CSI MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0600577
  • Facility Name: CSI MEDICAL GROUP
  • Facility Address: 13847 E 14TH ST STE 218
    SAN LEANDRO, CA
    ZIP 94578
  • Facility Phone: 510 483-0312
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WERNER W. JU MD
  • NPI Number: 1114953841
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0600577
LAB Type Physician Office
Facility Name CSI MEDICAL GROUP
Street 13847 E 14TH ST STE 218
City SAN LEANDRO
State CA
ZIP 94578
Phone 510 483-0312
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Physician Office
Lab Director WERNER W. JU MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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