05D0680747 CLIA NUMBER - CALIFORNIA POLY STATE UNIVERSITY STUDENT HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 05D0680747
  • Facility Name: CALIFORNIA POLY STATE UNIVERSITY STUDENT HEALTH SERVICES
  • Facility Address: 1 GRAND AVE
    SAN LUIS OBISPO, CA
    ZIP 93407
  • Facility Phone: 805 756-6276
  • Facility Type: School/Student Health Service
  • Facility Type: Accreditation
  • Lab Director: DR. RICARDO YOUNG
  • NPI Number: 1558485896
  • Taxonomy: 2255A2300X - Specialist/Technologist

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CLIA Record

Field Name Field Value
CLIA Number 05D0680747
LAB Type School/Student Health Service
Facility Name CALIFORNIA POLY STATE UNIVERSITY STUDENT HEALTH SERVICES
Street 1 GRAND AVE
City SAN LUIS OBISPO
State CA
ZIP 93407
Phone 805 756-6276
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type School/Student Health Service
Lab Director DR. RICARDO YOUNG

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