05D2262622 CLIA NUMBER - MARIN COMMUNITY CLINIC - WEST SAN RAFAEL

Laboratory Demographics

  • CLIA Code: 05D2262622
  • Facility Name: MARIN COMMUNITY CLINIC - WEST SAN RAFAEL
  • Facility Address: 1618 2ND ST
    SAN RAFAEL, CA
    ZIP 94901
  • Facility Phone: 415 448-1500
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: JOSE CHIBRAS
  • NPI Number: 1003900101
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2262622
LAB Type Federally Qualified Health Center
Facility Name MARIN COMMUNITY CLINIC - WEST SAN RAFAEL
Street 1618 2ND ST
City SAN RAFAEL
State CA
ZIP 94901
Phone 415 448-1500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Federally Qualified Health Center
Lab Director JOSE CHIBRAS

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