05D2165849 CLIA NUMBER - ADVENTIST HEALTH PHYSICIANS NETWORK MODESTO SPINE INSTITUTE

Laboratory Demographics

  • CLIA Code: 05D2165849
  • Facility Name: ADVENTIST HEALTH PHYSICIANS NETWORK MODESTO SPINE INSTITUTE
  • Facility Address: 200 WEST ROSEBURG AVENUE
    MODESTO, CA
    ZIP 95350
  • Facility Phone: 209 536-5776
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH GRANT
  • NPI Number: 1023575693
  • Taxonomy: 208600000X - Surgery

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2165849
LAB Type Physician Office
Facility Name ADVENTIST HEALTH PHYSICIANS NETWORK MODESTO SPINE INSTITUTE
Street 200 WEST ROSEBURG AVENUE
City MODESTO
State CA
ZIP 95350
Phone 209 536-5776
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2023
Certificate Expiration Date 5/6/2025
Facility Type Physician Office
Lab Director JOSEPH GRANT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025