05D1029490 CLIA NUMBER - SATELLITE HEALTHCARE CENTRAL MODESTO

Laboratory Demographics

  • CLIA Code: 05D1029490
  • Facility Name: SATELLITE HEALTHCARE CENTRAL MODESTO
  • Facility Address: 1315 10TH ST STE 300
    MODESTO, CA
    ZIP 95354
  • Facility Phone: 209 238-4087
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JOSE M. SANTOS, MD
  • NPI Number: 1609847581
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1029490
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SATELLITE HEALTHCARE CENTRAL MODESTO
Street 1315 10TH ST STE 300
City MODESTO
State CA
ZIP 95354
Phone 209 238-4087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JOSE M. SANTOS, MD

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