05D2160197 CLIA NUMBER - EVOLVE TREATMENT CENTERS SAN JOSE IOP / PHP

Laboratory Demographics

  • CLIA Code: 05D2160197
  • Facility Name: EVOLVE TREATMENT CENTERS SAN JOSE IOP / PHP
  • Facility Address: 1991 PARK AVE
    SAN JOSE, CA
    ZIP 95126
  • Facility Phone: 408 816-8431
  • Facility Type: Other - RESIDENTIAL TREATMENT
  • Facility Type: Waiver
  • Lab Director: SHIKHA VERMA
  • NPI Number: 1922581297
  • Taxonomy: 261QM0855X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2160197
LAB Type Other - RESIDENTIAL TREATMENT
Facility Name EVOLVE TREATMENT CENTERS SAN JOSE IOP / PHP
Street 1991 PARK AVE
City SAN JOSE
State CA
ZIP 95126
Phone 408 816-8431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Other - RESIDENTIAL TREATMENT
Lab Director SHIKHA VERMA

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