05D0872179 CLIA NUMBER - MEDICAL CENTER OF MARIN

Laboratory Demographics

CLIA Number: 05D0872179

Facility Name: MEDICAL CENTER OF MARIN

Facility Address:
101 CASA BUENA DRIVE
CORTE MADERA, CA
ZIP 94925
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Facility Phone Number: 415 924-4525

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1285145383

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0872179
LAB Type	Physician Office
Facility Name	MEDICAL CENTER OF MARIN
Street	101 CASA BUENA DRIVE
City	CORTE MADERA
State	CA
ZIP	94925
Phone	415 924-4525
CertificateType	4
CertificateEffectiveDate	10/18/2022
CertificateExpirationDate	10/17/2024
FacilityType	Waiver

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