05D2035389 CLIA NUMBER - BENJAMIN N WAN MD INC

Laboratory Demographics

  • CLIA Code: 05D2035389
  • Facility Name: BENJAMIN N WAN MD INC
  • Facility Address: 595 BUCKINGHAM WAY STE 500
    SAN FRANCISCO, CA
    ZIP 94132
  • Facility Phone: 415 665-6100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN N. WAN
  • NPI Number: 1942353032
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2035389
LAB Type Physician Office
Facility Name BENJAMIN N WAN MD INC
Street 595 BUCKINGHAM WAY STE 500
City SAN FRANCISCO
State CA
ZIP 94132
Phone 415 665-6100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Physician Office
Lab Director BENJAMIN N. WAN

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This page was last updated on: 3/20/2025