05D2167264 CLIA NUMBER - NORTH EAST MEDICAL SERVICES ELLIS CLINIC LAB

Laboratory Demographics

CLIA Number: 05D2167264

Facility Name: NORTH EAST MEDICAL SERVICES ELLIS CLINIC LAB

Facility Address:
650 POLK ST
SAN FRANCISCO, CA
ZIP 94102
Get Directions

Facility Phone Number: 415 391-9686

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1104103001

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2167264
LAB Type	Federally Qualified Health Center
Facility Name	NORTH EAST MEDICAL SERVICES ELLIS CLINIC LAB
Street	650 POLK ST
City	SAN FRANCISCO
State	CA
ZIP	94102
Phone	415 391-9686
CertificateType	4
CertificateEffectiveDate	6/5/2023
CertificateExpirationDate	6/4/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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