05D1089187 CLIA NUMBER - ADVENTIST HEALTH PHYSICIANS NETWORK

Laboratory Demographics

  • CLIA Code: 05D1089187
  • Facility Name: ADVENTIST HEALTH PHYSICIANS NETWORK
  • Facility Address: 10200 TRINITY PKWY STE 102
    STOCKTON, CA
    ZIP 95219
  • Facility Phone: 209 339-7411
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDMUND A. FREUND
  • NPI Number: 1255956132
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1089187
LAB Type Physician Office
Facility Name ADVENTIST HEALTH PHYSICIANS NETWORK
Street 10200 TRINITY PKWY STE 102
City STOCKTON
State CA
ZIP 95219
Phone 209 339-7411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2024
Certificate Expiration Date 7/6/2026
Facility Type Physician Office
Lab Director EDMUND A. FREUND

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