05D0710269 CLIA NUMBER - TUSHAR R MODI MD

Laboratory Demographics

  • CLIA Code: 05D0710269
  • Facility Name: TUSHAR R MODI MD
  • Facility Address: ORANGEBUGE MEDICAL PLAZA 413 E ORANGEBURG AVE SUITE A
    MODESTO, CA
    ZIP 95350
  • Facility Phone: 209 529-9600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TUSHAR R. MODI
  • NPI Number: 1679551352
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0710269
LAB Type Physician Office
Facility Name TUSHAR R MODI MD
Street ORANGEBUGE MEDICAL PLAZA 413 E ORANGEBURG AVE SUITE A
City MODESTO
State CA
ZIP 95350
Phone 209 529-9600
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 TUSHAR R. MODI

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