05D1083014 CLIA NUMBER - CENTRAL COAST ONCOLOGY & HEMATOLOGY

Laboratory Demographics

CLIA Number: 05D1083014

Facility Name: CENTRAL COAST ONCOLOGY & HEMATOLOGY

Facility Address:
1669 DOMINICAN WAY
SANTA CRUZ, CA
ZIP 95065
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Facility Phone Number: 831 475-2220

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1942473491

Taxonomy: 207RX0202X - Internal Medicine
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.

CLIA Record

Field Name	Field Value
CLIA Number	05D1083014
LAB Type	Physician Office
Facility Name	CENTRAL COAST ONCOLOGY & HEMATOLOGY
Street	1669 DOMINICAN WAY
City	SANTA CRUZ
State	CA
ZIP	95065
Phone	831 475-2220
CertificateType	2
CertificateEffectiveDate	2/11/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024