05D2002598 CLIA NUMBER - PHI AIR MEDICAL

Laboratory Demographics

  • CLIA Code: 05D2002598
  • Facility Name: PHI AIR MEDICAL
  • Facility Address: 801 AIRPORT WAY STE D
    MODESTO, CA
    ZIP 95354
  • Facility Phone: 209 550-0882
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: ROBERT DONOVAN
  • NPI Number: 1780630087
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 05D2002598
LAB Type Ambulance
Facility Name PHI AIR MEDICAL
Street 801 AIRPORT WAY STE D
City MODESTO
State CA
ZIP 95354
Phone 209 550-0882
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Ambulance
Lab Director ROBERT DONOVAN

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