05D0695064 CLIA NUMBER - JAGDISH A PATEL MD

Laboratory Demographics

  • CLIA Code: 05D0695064
  • Facility Name: JAGDISH A PATEL MD
  • Facility Address: 644 W 12TH STREET
    TRACY, CA
    ZIP 95376
  • Facility Phone: 209 832-8984
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAGDISH A. PATEL MD
  • NPI Number: 1407897481
  • Taxonomy: 207QA0505X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0695064
LAB Type Physician Office
Facility Name JAGDISH A PATEL MD
Street 644 W 12TH STREET
City TRACY
State CA
ZIP 95376
Phone 209 832-8984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JAGDISH A. PATEL MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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