05D2153550 CLIA NUMBER - PREMISE HEALTH OF CALIFORNIA MEDICAL, PC

Laboratory Demographics

  • CLIA Code: 05D2153550
  • Facility Name: PREMISE HEALTH OF CALIFORNIA MEDICAL, PC
  • Facility Address: 121 SPEAR STREET 4TH FL
    SAN FRANCISCO, CA
    ZIP 94105
  • Facility Phone: 888 926-9385
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT RODRIGUEZ
  • NPI Number: 1902395320
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2153550
LAB Type Physician Office
Facility Name PREMISE HEALTH OF CALIFORNIA MEDICAL, PC
Street 121 SPEAR STREET 4TH FL
City SAN FRANCISCO
State CA
ZIP 94105
Phone 888 926-9385
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director SCOTT RODRIGUEZ

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