05D0692679 CLIA NUMBER - SUTTER BAY MEDICAL FOUNDATION HEALTH CARE DIVISION

Laboratory Demographics

  • CLIA Code: 05D0692679
  • Facility Name: SUTTER BAY MEDICAL FOUNDATION HEALTH CARE DIVISION
  • Facility Address: 795 EL CAMINO REAL, AMES BLDG 2ND FL PATHOLOGY DEPARTMENT
    PALO ALTO, CA
    ZIP 94301
  • Facility Phone: 650 853-4811
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Accreditation
  • Lab Director: DR. JORGE P. RODRIGUEZ-SOTO
  • NPI Number: 1013950807
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0692679
LAB Type Ancillary Testing Site in Health Care Center
Facility Name SUTTER BAY MEDICAL FOUNDATION HEALTH CARE DIVISION
Street 795 EL CAMINO REAL, AMES BLDG 2ND FL PATHOLOGY DEPARTMENT
City PALO ALTO
State CA
ZIP 94301
Phone 650 853-4811
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 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. JORGE P. RODRIGUEZ-SOTO

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