05D0700750 CLIA NUMBER - LIZELLEN LA FOLLETTE MD

Laboratory Demographics

  • CLIA Code: 05D0700750
  • Facility Name: LIZELLEN LA FOLLETTE MD
  • Facility Address: 599 SIR FRANCIS DRAKE BLVD STE 301
    GREENBRAE, CA
    ZIP 94904
  • Facility Phone: 415 461-1949
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LIZELLEN LA FOLLETTE
  • NPI Number: 1710910153
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0700750
LAB Type Physician Office
Facility Name LIZELLEN LA FOLLETTE MD
Street 599 SIR FRANCIS DRAKE BLVD STE 301
City GREENBRAE
State CA
ZIP 94904
Phone 415 461-1949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Physician Office
Lab Director LIZELLEN LA FOLLETTE

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