05D0958039 CLIA NUMBER - PALO ALTO MEDICAL FOUNDATION LOS ALTOS CENTER

Laboratory Demographics

  • CLIA Code: 05D0958039
  • Facility Name: PALO ALTO MEDICAL FOUNDATION LOS ALTOS CENTER
  • Facility Address: 370 DISTEL CIRCLE
    LOS ALTOS, CA
    ZIP 94022
  • Facility Phone: 650 254-5293
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SHIV M. JAIN
  • NPI Number: 1982480059
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 05D0958039
LAB Type Physician Office
Facility Name PALO ALTO MEDICAL FOUNDATION LOS ALTOS CENTER
Street 370 DISTEL CIRCLE
City LOS ALTOS
State CA
ZIP 94022
Phone 650 254-5293
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Physician Office
Lab Director SHIV M. JAIN

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