05D2263611 CLIA NUMBER - VAN NESS OPCO TENANT LLC

Laboratory Demographics

  • CLIA Code: 05D2263611
  • Facility Name: VAN NESS OPCO TENANT LLC
  • Facility Address: 1001 VAN NESS AVENUE
    SAN FRANCISCO, CA
    ZIP 94109
  • Facility Phone: 305 546-8912
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: FAITH PROTSMAN
  • NPI Number: 1932572435
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D2263611
LAB Type Assisted Living Facility
Facility Name VAN NESS OPCO TENANT LLC
Street 1001 VAN NESS AVENUE
City SAN FRANCISCO
State CA
ZIP 94109
Phone 305 546-8912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Assisted Living Facility
Lab Director FAITH PROTSMAN

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