05D2100866 CLIA NUMBER - EVERGREEN URGENT CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D2100866
  • Facility Name: EVERGREEN URGENT CARE CENTER
  • Facility Address: 2365 QUIMBY RD STE 160
    SAN JOSE, CA
    ZIP 95122
  • Facility Phone: 408 550-2750
  • Facility Type: Other - URGENT CARE CENTER
  • Facility Type: Waiver
  • Lab Director: TAM H. NGUYEN
  • NPI Number: 1487048963
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2100866
LAB Type Other - URGENT CARE CENTER
Facility Name EVERGREEN URGENT CARE CENTER
Street 2365 QUIMBY RD STE 160
City SAN JOSE
State CA
ZIP 95122
Phone 408 550-2750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Other - URGENT CARE CENTER
Lab Director TAM H. NGUYEN

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