05D2063037 CLIA NUMBER - TULLY ROAD HOME TRAINING

Laboratory Demographics

  • CLIA Code: 05D2063037
  • Facility Name: TULLY ROAD HOME TRAINING
  • Facility Address: 1290 TULLY RD STE 60
    SAN JOSE, CA
    ZIP 95122
  • Facility Phone: 626 960-9404
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: PHILIP TSE
  • NPI Number: 1538400239
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2063037
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TULLY ROAD HOME TRAINING
Street 1290 TULLY RD STE 60
City SAN JOSE
State CA
ZIP 95122
Phone 626 960-9404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director PHILIP TSE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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