05D2172281 CLIA NUMBER - PENINSULA OBGYN INTEGRATIVE

Laboratory Demographics

CLIA Number: 05D2172281

Facility Name: PENINSULA OBGYN INTEGRATIVE

Facility Address:
101 SOUTH SAN MATEO DRIVE SUITE 111
SAN MATEO, CA
ZIP 94401
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Facility Phone Number: 650 542-0092

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1669957114

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	05D2172281
LAB Type	Physician Office
Facility Name	PENINSULA OBGYN INTEGRATIVE
Street	101 SOUTH SAN MATEO DRIVE SUITE 111
City	SAN MATEO
State	CA
ZIP	94401
Phone	650 542-0092
CertificateType	3
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	PPMP

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