05D0980628 CLIA NUMBER - CAL PEP MOBILE VAN

Laboratory Demographics

  • CLIA Code: 05D0980628
  • Facility Name: CAL PEP MOBILE VAN
  • Facility Address: 2811 ADELINE ST
    OAKLAND, CA
    ZIP 94608
  • Facility Phone: 510 874-7850
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: CHRISTOPHER HALL
  • NPI Number: 1174059653
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 05D0980628
LAB Type Community Clinic
Facility Name CAL PEP MOBILE VAN
Street 2811 ADELINE ST
City OAKLAND
State CA
ZIP 94608
Phone 510 874-7850
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 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Community Clinic
Lab Director CHRISTOPHER HALL

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