05D0665802 CLIA NUMBER - UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY- MENDOTA

Laboratory Demographics

  • CLIA Code: 05D0665802
  • Facility Name: UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY- MENDOTA
  • Facility Address: 119 BARBOZA ST, BLDG 1
    MENDOTA, CA
    ZIP 93640
  • Facility Phone: 559 655-5000
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: BANUJAN BALACHANDRAN
  • NPI Number: 1871695130
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D0665802
LAB Type Federally Qualified Health Center
Facility Name UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY- MENDOTA
Street 119 BARBOZA ST, BLDG 1
City MENDOTA
State CA
ZIP 93640
Phone 559 655-5000
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 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Federally Qualified Health Center
Lab Director BANUJAN BALACHANDRAN

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