05D1046523 CLIA NUMBER - RENE H BRAVO, MD, INC

Laboratory Demographics

  • CLIA Code: 05D1046523
  • Facility Name: RENE H BRAVO, MD, INC
  • Facility Address: 3241 S HIGUERA
    SAN LUIS OBISPO, CA
    ZIP 93401
  • Facility Phone: 805 544-4460
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RENE H. BRAVO, MD
  • NPI Number: 1255373965
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1046523
LAB Type Physician Office
Facility Name RENE H BRAVO, MD, INC
Street 3241 S HIGUERA
City SAN LUIS OBISPO
State CA
ZIP 93401
Phone 805 544-4460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Physician Office
Lab Director RENE H. BRAVO, MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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