05D2083312 CLIA NUMBER - EDGEWOOD CENTER FOR CHILDREN AND FAMILIES

Laboratory Demographics

CLIA Code: 05D2083312
Facility Name: EDGEWOOD CENTER FOR CHILDREN AND FAMILIES
Facility Address: 1801 VICENTE ST
SAN FRANCISCO, CA
ZIP 94116
Facility Phone: 415 681-3211
Facility Type: Other - RESIDENTIAL TRT FACILITY
Facility Type: Waiver
Lab Director: ROBIN R. RANDALL, MD
NPI Number: 1801056395
Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children

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CLIA Record

Field Name	Field Value
CLIA Number	05D2083312
LAB Type	Other - RESIDENTIAL TRT FACILITY
Facility Name	EDGEWOOD CENTER FOR CHILDREN AND FAMILIES
Street	1801 VICENTE ST
City	SAN FRANCISCO
State	CA
ZIP	94116
Phone	415 681-3211
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/3/2024
Certificate Expiration Date	9/2/2026
Facility Type	Other - RESIDENTIAL TRT FACILITY
Lab Director	ROBIN R. RANDALL, MD

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