05D2139767 CLIA NUMBER - CCRM SAN FRANCISCO, LLC

Laboratory Demographics

  • CLIA Code: 05D2139767
  • Facility Name: CCRM SAN FRANCISCO, LLC
  • Facility Address: 1060 MARSH RD, 1ST FL
    MENLO PARK, CA
    ZIP 94025
  • Facility Phone: 734 645-0119
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. SALLI I. TAZUKE
  • NPI Number: 1609357169
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D2139767
LAB Type Physician Office
Facility Name CCRM SAN FRANCISCO, LLC
Street 1060 MARSH RD, 1ST FL
City MENLO PARK
State CA
ZIP 94025
Phone 734 645-0119
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Physician Office
Lab Director DR. SALLI I. TAZUKE

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