05D1047330 CLIA NUMBER - DIABLO VALLEY PRIMARY CARE, INC

Laboratory Demographics

  • CLIA Code: 05D1047330
  • Facility Name: DIABLO VALLEY PRIMARY CARE, INC
  • Facility Address: 2415 HIGH SCHOOL AVE STE 800
    CONCORD, CA
    ZIP 94520
  • Facility Phone: 925 687-5210
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHINNAVUTH P. DE MONTEIRO, MD
  • NPI Number: 1073823332
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1047330
LAB Type Physician Office
Facility Name DIABLO VALLEY PRIMARY CARE, INC
Street 2415 HIGH SCHOOL AVE STE 800
City CONCORD
State CA
ZIP 94520
Phone 925 687-5210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director CHINNAVUTH P. DE MONTEIRO, MD

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