05D2178582 CLIA NUMBER - MOGO URGENT CARE

Laboratory Demographics

CLIA Number: 05D2178582

Facility Name: MOGO URGENT CARE

Facility Address:
2930 SECOND AVENUE, SUITE 120
MARINA, CA
ZIP 93933
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Facility Phone Number: 831 622-5805

Facility Type: Other - URGENT CARE CLINIC

Certificate Type: Waiver

NPI Number: 1326660598

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2178582
LAB Type	Other - URGENT CARE CLINIC
Facility Name	MOGO URGENT CARE
Street	2930 SECOND AVENUE, SUITE 120
City	MARINA
State	CA
ZIP	93933
Phone	831 622-5805
CertificateType	4
CertificateEffectiveDate	2/5/2024
CertificateExpirationDate	2/4/2026
FacilityType	Waiver

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