05D0609827 CLIA NUMBER - VIRGILIO C ERESO MD

Laboratory Demographics

  • CLIA Code: 05D0609827
  • Facility Name: VIRGILIO C ERESO MD
  • Facility Address: 500 COFFEE ROAD, #A
    MODESTO, CA
    ZIP 95355
  • Facility Phone: 209 579-7461
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VIRGILIO C. ERESO
  • NPI Number: 1063698041
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0609827
LAB Type Physician Office
Facility Name VIRGILIO C ERESO MD
Street 500 COFFEE ROAD, #A
City MODESTO
State CA
ZIP 95355
Phone 209 579-7461
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director VIRGILIO C. ERESO

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