05D0686317 CLIA NUMBER - VALLEY OAK PEDIATRIC ASSOCIATES

Laboratory Demographics

  • CLIA Code: 05D0686317
  • Facility Name: VALLEY OAK PEDIATRIC ASSOCIATES
  • Facility Address: 4120 PRESCOTT RD
    MODESTO, CA
    ZIP 95356
  • Facility Phone: 209 544-7300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTINE CHAN
  • NPI Number: 1407843345
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0686317
LAB Type Physician Office
Facility Name VALLEY OAK PEDIATRIC ASSOCIATES
Street 4120 PRESCOTT RD
City MODESTO
State CA
ZIP 95356
Phone 209 544-7300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director CHRISTINE CHAN

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