05D2241990 CLIA NUMBER - GL CA CLIA LLC

Laboratory Demographics

  • CLIA Code: 05D2241990
  • Facility Name: GL CA CLIA LLC
  • Facility Address: 5500 STEWART AVE STE 108
    FREMONT, CA
    ZIP 94538
  • Facility Phone: 510 203-6087
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. CARL E. JOHNSON
  • NPI Number: 1578220026
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D2241990
LAB Type Independent
Facility Name GL CA CLIA LLC
Street 5500 STEWART AVE STE 108
City FREMONT
State CA
ZIP 94538
Phone 510 203-6087
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/13/2023
Certificate Expiration Date 10/31/2025
Facility Type Independent
Lab Director DR. CARL E. JOHNSON

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