05D0996809 CLIA NUMBER - MIDDLE PATH MEDICINE

Laboratory Demographics

  • CLIA Code: 05D0996809
  • Facility Name: MIDDLE PATH MEDICINE
  • Facility Address: 180 WEST LE POINT STREET, SUITE A
    ARROYO GRANDE, CA
    ZIP 93420
  • Facility Phone: 805 481-3442
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARY E. FORESMAN,MD
  • NPI Number: 1497924260
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0996809
LAB Type Physician Office
Facility Name MIDDLE PATH MEDICINE
Street 180 WEST LE POINT STREET, SUITE A
City ARROYO GRANDE
State CA
ZIP 93420
Phone 805 481-3442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director GARY E. FORESMAN,MD

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