05D0601536 CLIA NUMBER - JOHN MUIR PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 05D0601536
  • Facility Name: JOHN MUIR PHYSICIAN NETWORK
  • Facility Address: 100 N WIGET LN STE 290
    WALNUT CREEK, CA
    ZIP 94598
  • Facility Phone: 925 952-2818
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. RICHARD LONG
  • NPI Number: 1235184110
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 05D0601536
LAB Type Physician Office
Facility Name JOHN MUIR PHYSICIAN NETWORK
Street 100 N WIGET LN STE 290
City WALNUT CREEK
State CA
ZIP 94598
Phone 925 952-2818
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 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Physician Office
Lab Director DR. RICHARD LONG

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