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05D2051767 CLIA NUMBER - LA CLINICA DE LA RAZA - PRIMARY CARE

Laboratory Demographics

CLIA Number: 05D2051767

Facility Name: LA CLINICA DE LA RAZA - PRIMARY CARE

Facility Address:
3451 E 12TH ST 2ND FL
OAKLAND, CA
ZIP 94601
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Facility Phone Number: 510 535-3524

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy
NPI Number: 1851788004

Taxonomy: 124Q00000X - Dental Hygienist
An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.

CLIA Record

Field Name Field Value
CLIA Number 05D2051767
LAB Type Federally Qualified Health Center
Facility Name LA CLINICA DE LA RAZA - PRIMARY CARE
Street 3451 E 12TH ST 2ND FL
City OAKLAND
State CA
ZIP 94601
Phone 510 535-3524
CertificateType 3
CertificateEffectiveDate 12/27/2022
CertificateExpirationDate 12/26/2024
FacilityType PPMP

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