05D1099278 CLIA NUMBER - SUSAN GUTIERREZ, MD

Laboratory Demographics

  • CLIA Code: 05D1099278
  • Facility Name: SUSAN GUTIERREZ, MD
  • Facility Address: 100 PARK PL STE 120
    SAN RAMON, CA
    ZIP 94583
  • Facility Phone: 925 806-0757
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUAN GUTIERREZ
  • NPI Number: 1518961127
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1099278
LAB Type Physician Office
Facility Name SUSAN GUTIERREZ, MD
Street 100 PARK PL STE 120
City SAN RAMON
State CA
ZIP 94583
Phone 925 806-0757
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Physician Office
Lab Director SUAN GUTIERREZ

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