05D2090913 CLIA NUMBER - BONITA HOUSE INC

Laboratory Demographics

  • CLIA Code: 05D2090913
  • Facility Name: BONITA HOUSE INC
  • Facility Address: 6333 TELEGRAPH AVE STE 102
    OAKLAND, CA
    ZIP 94609
  • Facility Phone: 510 923-1099
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: FLOYD M. BROWN
  • NPI Number: 1245925536
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2090913
LAB Type Community Clinic
Facility Name BONITA HOUSE INC
Street 6333 TELEGRAPH AVE STE 102
City OAKLAND
State CA
ZIP 94609
Phone 510 923-1099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type Community Clinic
Lab Director FLOYD M. BROWN

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