05D2078277 CLIA NUMBER - SATELLITE HEALTHCARE SAN JOSE

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Laboratory Demographics

CLIA Number: 05D2078277

Facility Name: SATELLITE HEALTHCARE SAN JOSE

Facility Address:
888 S BASCOM AVE
SAN JOSE, CA
ZIP 95128
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Facility Phone Number: 408 855-6900

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1972927960

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2078277
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	SATELLITE HEALTHCARE SAN JOSE
Street	888 S BASCOM AVE
City	SAN JOSE
State	CA
ZIP	95128
Phone	408 855-6900
CertificateType	4
CertificateEffectiveDate	5/23/2022
CertificateExpirationDate	5/22/2024
FacilityType	Waiver

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