05D0955807 CLIA NUMBER - SOUTH COUNTY COMMUNITY HEALTH CENTER DBA RAVENSWOOD FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D0955807

Facility Name: SOUTH COUNTY COMMUNITY HEALTH CENTER DBA RAVENSWOOD FAMILY HEALTH CENTER

Facility Address:
1885 BAY RD
EAST PALO ALTO, CA
ZIP 94303
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Facility Phone Number: 650 289-7613

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1184957771

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0955807
LAB Type	Federally Qualified Health Center
Facility Name	SOUTH COUNTY COMMUNITY HEALTH CENTER DBA RAVENSWOOD FAMILY HEALTH CENTER
Street	1885 BAY RD
City	EAST PALO ALTO
State	CA
ZIP	94303
Phone	650 289-7613
CertificateType	3
CertificateEffectiveDate	1/11/2023
CertificateExpirationDate	1/10/2025
FacilityType	PPMP

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