05D0918530 CLIA NUMBER - JACQUELYNN L TSU, MD

Laboratory Demographics

  • CLIA Code: 05D0918530
  • Facility Name: JACQUELYNN L TSU, MD
  • Facility Address: 2101 FOREST AVE, STE 128
    SAN JOSE, CA
    ZIP 95128
  • Facility Phone: 408 295-9151
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELYNN L. TSU
  • NPI Number: 1063447076
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0918530
LAB Type Physician Office
Facility Name JACQUELYNN L TSU, MD
Street 2101 FOREST AVE, STE 128
City SAN JOSE
State CA
ZIP 95128
Phone 408 295-9151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Physician Office
Lab Director JACQUELYNN L. TSU

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