05D2108713 CLIA NUMBER - ADVENTIST HEALTH PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 05D2108713
  • Facility Name: ADVENTIST HEALTH PHYSICIAN NETWORK
  • Facility Address: 35 CASA ST, STE 130
    SAN LUIS OBISPO, CA
    ZIP 93405
  • Facility Phone: 805 792-2112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BHAVISHYA CLARK
  • NPI Number: 1063820728
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2108713
LAB Type Physician Office
Facility Name ADVENTIST HEALTH PHYSICIAN NETWORK
Street 35 CASA ST, STE 130
City SAN LUIS OBISPO
State CA
ZIP 93405
Phone 805 792-2112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Physician Office
Lab Director BHAVISHYA CLARK

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