05D1089184 CLIA NUMBER - LAUREL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D1089184
  • Facility Name: LAUREL PEDIATRICS
  • Facility Address: 3055 MACARTHUR BLVD
    OAKLAND, CA
    ZIP 94602
  • Facility Phone: 510 530-1111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CAROL E. GLANN, MD
  • NPI Number: 1396911806
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1089184
LAB Type Physician Office
Facility Name LAUREL PEDIATRICS
Street 3055 MACARTHUR BLVD
City OAKLAND
State CA
ZIP 94602
Phone 510 530-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Physician Office
Lab Director CAROL E. GLANN, MD

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