05D0956654 CLIA NUMBER - PREVENTIVE CARE NETWORK MEDICAL SERVICES, INC

Laboratory Demographics

CLIA Number: 05D0956654

Facility Name: PREVENTIVE CARE NETWORK MEDICAL SERVICES, INC

Facility Address:
5709 MARKET ST
OAKLAND, CA
ZIP 94608
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Facility Phone Number: (510) 444-9460

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1447588330

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0956654
LAB Type	PHYSICIAN OFFICE
Facility Name	PREVENTIVE CARE NETWORK MEDICAL SERVICES, INC
Street	5709 MARKET ST
City	OAKLAND
State	CA
ZIP	94608
Phone	(510) 444-9460

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This page was last updated on: 5/11/2023