05D2216117 CLIA NUMBER - DAN BORGSTADT, MD, INC

Laboratory Demographics

  • CLIA Code: 05D2216117
  • Facility Name: DAN BORGSTADT, MD, INC
  • Facility Address: 255 W. HERNDON AVE. STE 103
    CLOVIS, CA
    ZIP 93612
  • Facility Phone: 559 326-2999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL L. BORGSTADT
  • NPI Number: 1508515479
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2216117
LAB Type Physician Office
Facility Name DAN BORGSTADT, MD, INC
Street 255 W. HERNDON AVE. STE 103
City CLOVIS
State CA
ZIP 93612
Phone 559 326-2999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Physician Office
Lab Director DANIEL L. BORGSTADT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025