05D2105330 CLIA NUMBER - ONE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D2105330
  • Facility Name: ONE MEDICAL GROUP
  • Facility Address: 746 THE ALAMEDA
    SAN JOSE, CA
    ZIP 95126
  • Facility Phone: 408 228-1028
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAEPHANH KHAE
  • NPI Number: 1376189837
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2105330
LAB Type Physician Office
Facility Name ONE MEDICAL GROUP
Street 746 THE ALAMEDA
City SAN JOSE
State CA
ZIP 95126
Phone 408 228-1028
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/23/2023
Certificate Expiration Date 11/22/2025
Facility Type Physician Office
Lab Director SAEPHANH KHAE

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