05D1103381 CLIA NUMBER - PINNACLE MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D1103381

Facility Name: PINNACLE MEDICAL GROUP INC

Facility Address:
1180 BROADWAY ST
KING CITY, CA
ZIP 93930
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Facility Phone Number: 831 385-8000

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1669557930

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1103381
LAB Type	Other
Facility Name	PINNACLE MEDICAL GROUP INC
Street	1180 BROADWAY ST
City	KING CITY
State	CA
ZIP	93930
Phone	831 385-8000
CertificateType	4
CertificateEffectiveDate	8/10/2023
CertificateExpirationDate	8/9/2025
FacilityType	Waiver

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