05D2267702 CLIA NUMBER - OPO HEAL TH, LLC

Laboratory Demographics

  • CLIA Code: 05D2267702
  • Facility Name: OPO HEAL TH, LLC
  • Facility Address: 1528 S EL CAMINO REAL, SUITE 108
    SAN MATEO, CA
    ZIP 94402
  • Facility Phone: 650 288-0130
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MELISSA A. FREDERICK
  • NPI Number: 1801403506
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2267702
LAB Type Home Health Agency
Facility Name OPO HEAL TH, LLC
Street 1528 S EL CAMINO REAL, SUITE 108
City SAN MATEO
State CA
ZIP 94402
Phone 650 288-0130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Home Health Agency
Lab Director MELISSA A. FREDERICK

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