05D2150501 CLIA NUMBER - PALO ALTO MEDICAL FOUNDATION FOR HEALTH CARE, RESEARCH AND EDUCATION

Laboratory Demographics

CLIA Number: 05D2150501

Facility Name: PALO ALTO MEDICAL FOUNDATION FOR HEALTH CARE, RESEARCH AND EDUCATION

Facility Address:
1950 UNIVERSITY AVE STE 170
EAST PALO ALTO, CA
ZIP 94303
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Facility Phone Number: 408 402-9210

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Certificate of Compliance

NPI Number: 1639729932

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2150501
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	PALO ALTO MEDICAL FOUNDATION FOR HEALTH CARE, RESEARCH AND EDUCATION
Street	1950 UNIVERSITY AVE STE 170
City	EAST PALO ALTO
State	CA
ZIP	94303
Phone	408 402-9210
CertificateType	2
CertificateEffectiveDate	7/17/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024