05D2281964 CLIA NUMBER - KAISER FOUNDATION HEALTH PLAN

Laboratory Demographics

  • CLIA Code: 05D2281964
  • Facility Name: KAISER FOUNDATION HEALTH PLAN
  • Facility Address: 43971 BOSCELL RD
    FREMONT, CA
    ZIP 94538
  • Facility Phone: 510 248-7724
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY MOORE
  • NPI Number: 1215085188
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2281964
LAB Type Physician Office
Facility Name KAISER FOUNDATION HEALTH PLAN
Street 43971 BOSCELL RD
City FREMONT
State CA
ZIP 94538
Phone 510 248-7724
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director JEFFREY MOORE

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