05D2270678 CLIA NUMBER - LILY ENAYATI MD INC

Laboratory Demographics

  • CLIA Code: 05D2270678
  • Facility Name: LILY ENAYATI MD INC
  • Facility Address: 1 BAYWOOD AVE SUITE 10
    SAN MATEO, CA
    ZIP 94402
  • Facility Phone: 650 342-2974
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LILY ENAYATI
  • NPI Number: 1447322847
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2270678
LAB Type Physician Office
Facility Name LILY ENAYATI MD INC
Street 1 BAYWOOD AVE SUITE 10
City SAN MATEO
State CA
ZIP 94402
Phone 650 342-2974
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director LILY ENAYATI

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