05D0726468 CLIA NUMBER - BROOKSIDE SKILLED NURSING HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0726468
  • Facility Name: BROOKSIDE SKILLED NURSING HOSPITAL
  • Facility Address: 2620 FLORES ST
    SAN MATEO, CA
    ZIP 94403
  • Facility Phone: 415 349-2161
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: STANLEY G. COPPEL
  • NPI Number: 1952393076
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0726468
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BROOKSIDE SKILLED NURSING HOSPITAL
Street 2620 FLORES ST
City SAN MATEO
State CA
ZIP 94403
Phone 415 349-2161
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 Skilled Nursing Facility/Nursing Facility
Lab Director STANLEY G. COPPEL

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