05D2102192 CLIA NUMBER - CROSSOVER HEALTH

Laboratory Demographics

  • CLIA Code: 05D2102192
  • Facility Name: CROSSOVER HEALTH
  • Facility Address: 1080A LA AVENIDA ST
    MOUNTAIN VIEW, CA
    ZIP 94043
  • Facility Phone: 949 891-0328
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN EZEJI-OKOYE
  • NPI Number: 1972121069
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D2102192
LAB Type Physician Office
Facility Name CROSSOVER HEALTH
Street 1080A LA AVENIDA ST
City MOUNTAIN VIEW
State CA
ZIP 94043
Phone 949 891-0328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Physician Office
Lab Director STEPHEN EZEJI-OKOYE

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