05D0863261 CLIA NUMBER - LUIS A BONILLA, MD

Laboratory Demographics

CLIA Number: 05D0863261

Facility Name: LUIS A BONILLA, MD

Facility Address:
1580 VALENCIA ST STE 803B
SAN FRANCISCO, CA
ZIP 94110
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Facility Phone Number: 415 285-7940

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1629019708

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024