05D0926513 CLIA NUMBER - MARIN COMMUNITY CLINIC

Laboratory Demographics

CLIA Number: 05D0926513

Facility Name: MARIN COMMUNITY CLINIC

Facility Address:
5 BON AIR RD STE 117
LARKSPUR, CA
ZIP 94939
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Facility Phone Number: 415 448-1500

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1780292912

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0926513
LAB Type	Federally Qualified Health Center
Facility Name	MARIN COMMUNITY CLINIC
Street	5 BON AIR RD STE 117
City	LARKSPUR
State	CA
ZIP	94939
Phone	415 448-1500
CertificateType	3
CertificateEffectiveDate	7/10/2022
CertificateExpirationDate	7/9/2024
FacilityType	PPMP

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