05D2192522 CLIA NUMBER - MOGO URGENT CARE

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Laboratory Demographics

CLIA Number: 05D2192522

Facility Name: MOGO URGENT CARE

Facility Address:
26135 CARMEK RANCHO BOULEVARD SUITE B-1
CARMEL, CA
ZIP 93923
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Facility Phone Number: 831 622-5805

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1780299032

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2192522
LAB Type	Other - URGENT CARE
Facility Name	MOGO URGENT CARE
Street	26135 CARMEK RANCHO BOULEVARD SUITE B-1
City	CARMEL
State	CA
ZIP	93923
Phone	831 622-5805
CertificateType	4
CertificateEffectiveDate	9/10/2022
CertificateExpirationDate	9/9/2024
FacilityType	Waiver

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