05D0863261 CLIA NUMBER - LUIS A BONILLA, MD

Laboratory Demographics

  • CLIA Code: 05D0863261
  • Facility Name: LUIS A BONILLA, MD
  • Facility Address: 1580 VALENCIA ST STE 803B
    SAN FRANCISCO, CA
    ZIP 94110
  • Facility Phone: 415 285-7940
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LUIS A. BONILLA
  • NPI Number: 1629019708
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0863261
LAB Type Physician Office
Facility Name LUIS A BONILLA, MD
Street 1580 VALENCIA ST STE 803B
City SAN FRANCISCO
State CA
ZIP 94110
Phone 415 285-7940
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 LUIS A. BONILLA

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