05D1083684 CLIA NUMBER - MINIMALLY INVASIVE SURGICAL SOLUTIONS

Laboratory Demographics

CLIA Number: 05D1083684

Facility Name: MINIMALLY INVASIVE SURGICAL SOLUTIONS

Facility Address:
105 N BASCOM STE 104
SAN JOSE, CA
ZIP 95128
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Facility Phone Number: 408 918-0405

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1821167628

Taxonomy: 2085R0204X - Radiology
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

CLIA Record

Field Name	Field Value
CLIA Number	05D1083684
LAB Type	Physician Office
Facility Name	MINIMALLY INVASIVE SURGICAL SOLUTIONS
Street	105 N BASCOM STE 104
City	SAN JOSE
State	CA
ZIP	95128
Phone	408 918-0405
CertificateType	4
CertificateEffectiveDate	5/8/2024
CertificateExpirationDate	5/7/2026
FacilityType	Waiver

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