05D0717291 CLIA NUMBER - DUNG MY PHAN, MD INC

Laboratory Demographics

  • CLIA Code: 05D0717291
  • Facility Name: DUNG MY PHAN, MD INC
  • Facility Address: 1693 FLANIGAN DR STE 100
    SAN JOSE, CA
    ZIP 95121
  • Facility Phone: 408 274-3881
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DUNG M. PHAN, MD
  • NPI Number: 1104261700
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0717291
LAB Type Physician Office
Facility Name DUNG MY PHAN, MD INC
Street 1693 FLANIGAN DR STE 100
City SAN JOSE
State CA
ZIP 95121
Phone 408 274-3881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2024
Certificate Expiration Date 6/26/2026
Facility Type Physician Office
Lab Director DUNG M. PHAN, MD

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