05D2070274 CLIA NUMBER - JEFFREY M BLOOM, MD INC

Laboratory Demographics

  • CLIA Code: 05D2070274
  • Facility Name: JEFFREY M BLOOM, MD INC
  • Facility Address: 1318 JOHNSON AVE
    SAN LUIS OBISPO, CA
    ZIP 93401
  • Facility Phone: 805 541-2300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY M. BLOOM
  • NPI Number: 1154346377
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2070274
LAB Type Physician Office
Facility Name JEFFREY M BLOOM, MD INC
Street 1318 JOHNSON AVE
City SAN LUIS OBISPO
State CA
ZIP 93401
Phone 805 541-2300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Physician Office
Lab Director JEFFREY M. BLOOM

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