05D1079985 CLIA NUMBER - GARTH TANNER MD

Laboratory Demographics

  • CLIA Code: 05D1079985
  • Facility Name: GARTH TANNER MD
  • Facility Address: 1429 COLLEGE AVE # K
    MODESTO, CA
    ZIP 95350
  • Facility Phone: 209 521-7800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARTH TANNER
  • NPI Number: 1184612624
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1079985
LAB Type Physician Office
Facility Name GARTH TANNER MD
Street 1429 COLLEGE AVE # K
City MODESTO
State CA
ZIP 95350
Phone 209 521-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Physician Office
Lab Director GARTH TANNER

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