05D2178593 CLIA NUMBER - SERES PRIME HEALTHCARE

Laboratory Demographics

CLIA Number: 05D2178593

Facility Name: SERES PRIME HEALTHCARE

Facility Address:
841 BLOSSOM HILL ROAD SUITE 215
SAN JOSE, CA
ZIP 95123
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Facility Phone Number: 408 629-7095

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306483839

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2178593
LAB Type	Physician Office
Facility Name	SERES PRIME HEALTHCARE
Street	841 BLOSSOM HILL ROAD SUITE 215
City	SAN JOSE
State	CA
ZIP	95123
Phone	408 629-7095
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