05D2074378 CLIA NUMBER - KEN STARR MD WELLNESS GROUP

Laboratory Demographics

  • CLIA Code: 05D2074378
  • Facility Name: KEN STARR MD WELLNESS GROUP
  • Facility Address: 107 NELSON STREET
    ARROYO GRANDE, CA
    ZIP 93420
  • Facility Phone: 805 242-1360
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEN STARR, MD
  • NPI Number: 1598195810
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2074378
LAB Type Physician Office
Facility Name KEN STARR MD WELLNESS GROUP
Street 107 NELSON STREET
City ARROYO GRANDE
State CA
ZIP 93420
Phone 805 242-1360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Physician Office
Lab Director KEN STARR, MD

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