05D1089184 CLIA NUMBER - LAUREL PEDIATRICS

Laboratory Demographics

CLIA Number: 05D1089184

Facility Name: LAUREL PEDIATRICS

Facility Address:
3055 MACARTHUR BLVD
OAKLAND, CA
ZIP 94602
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Facility Phone Number: 510 530-1111

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396911806

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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
CertificateType	4
CertificateEffectiveDate	9/11/2022
CertificateExpirationDate	9/10/2024
FacilityType	Waiver

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