05D1102498 CLIA NUMBER - PURISIMA FAMILY MEDICINE INC

Laboratory Demographics

CLIA Number: 05D1102498

Facility Name: PURISIMA FAMILY MEDICINE INC

Facility Address:
575 KELLY ST
HALF MOON BAY, CA
ZIP 94019
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Facility Phone Number: 650 560-0216

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1881821387

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D1102498
LAB Type	Physician Office
Facility Name	PURISIMA FAMILY MEDICINE INC
Street	575 KELLY ST
City	HALF MOON BAY
State	CA
ZIP	94019
Phone	650 560-0216
CertificateType	4
CertificateEffectiveDate	7/20/2023
CertificateExpirationDate	7/19/2025
FacilityType	Waiver

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