05D2172070 CLIA NUMBER - WILSHIRE CONNECTED CARE

Laboratory Demographics

  • CLIA Code: 05D2172070
  • Facility Name: WILSHIRE CONNECTED CARE
  • Facility Address: 277 SOUTH STREET, SUITE S
    SAN LUIS OBISPO, CA
    ZIP 93401
  • Facility Phone: 800 870-5920
  • Facility Type: Other - PRIMARY CARE
  • Facility Type: Waiver
  • Lab Director: KEVIN PARZYCH
  • NPI Number: 1104392885
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2172070
LAB Type Other - PRIMARY CARE
Facility Name WILSHIRE CONNECTED CARE
Street 277 SOUTH STREET, SUITE S
City SAN LUIS OBISPO
State CA
ZIP 93401
Phone 800 870-5920
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Other - PRIMARY CARE
Lab Director KEVIN PARZYCH

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