05D0603607 CLIA NUMBER - BERKELEY PEDIATRIC MEDICAL GROUP LAB

Laboratory Demographics

  • CLIA Code: 05D0603607
  • Facility Name: BERKELEY PEDIATRIC MEDICAL GROUP LAB
  • Facility Address: 1650 WALNUT STREET
    BERKELEY, CA
    ZIP 94709
  • Facility Phone: 510 848-2566
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANNEMARY FRANKS
  • NPI Number: 1407873425
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0603607
LAB Type Physician Office
Facility Name BERKELEY PEDIATRIC MEDICAL GROUP LAB
Street 1650 WALNUT STREET
City BERKELEY
State CA
ZIP 94709
Phone 510 848-2566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Physician Office
Lab Director ANNEMARY FRANKS

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