05D2196496 CLIA NUMBER - CLOUD CARE OPERATED BY PREMISE HEALTH

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Laboratory Demographics

CLIA Number: 05D2196496

Facility Name: CLOUD CARE OPERATED BY PREMISE HEALTH

Facility Address:
6140 STONERIDGE MALL RD
PLEASANTON, CA
ZIP 94588
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Facility Phone Number: 877 967-5329

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1568077089

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2196496
LAB Type	Physician Office
Facility Name	CLOUD CARE OPERATED BY PREMISE HEALTH
Street	6140 STONERIDGE MALL RD
City	PLEASANTON
State	CA
ZIP	94588
Phone	877 967-5329
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

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