05D2094905 CLIA NUMBER - KARLENE BERT

Laboratory Demographics

  • CLIA Code: 05D2094905
  • Facility Name: KARLENE BERT
  • Facility Address: 1878 E HATCH RD
    MODESTO, CA
    ZIP 95351
  • Facility Phone: 209 538-1496
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDWARD SCHELLINCK
  • NPI Number: 1053511378
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 05D2094905
LAB Type Physician Office
Facility Name KARLENE BERT
Street 1878 E HATCH RD
City MODESTO
State CA
ZIP 95351
Phone 209 538-1496
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2023
Certificate Expiration Date 4/26/2025
Facility Type Physician Office
Lab Director EDWARD SCHELLINCK

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This page was last updated on: 3/20/2025