05D1058034 CLIA NUMBER - MINA SEHHAT MD

Laboratory Demographics

  • CLIA Code: 05D1058034
  • Facility Name: MINA SEHHAT MD
  • Facility Address: 2101 FOREST AVENUE, SUITE 104
    SAN JOSE, CA
    ZIP 95128
  • Facility Phone: 408 975-7680
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINA SEHHAT
  • NPI Number: 1558393314
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D1058034
LAB Type Physician Office
Facility Name MINA SEHHAT MD
Street 2101 FOREST AVENUE, SUITE 104
City SAN JOSE
State CA
ZIP 95128
Phone 408 975-7680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Physician Office
Lab Director MINA SEHHAT

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