05D2287864 CLIA NUMBER - CLINICA SIERRA VISTA (DBA) FRESNO MOBILE UNIT

Laboratory Demographics

  • CLIA Code: 05D2287864
  • Facility Name: CLINICA SIERRA VISTA (DBA) FRESNO MOBILE UNIT
  • Facility Address: 2740 S ELM AVE VIN# 1FDNF6AN5PDF01269
    FRESNO, CA
    ZIP 93706
  • Facility Phone: 661 635-3050
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: FERISHTA GOUSSE
  • NPI Number: 1700910080
  • Taxonomy: 261QF0050X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2287864
LAB Type Mobile Laboratory
Facility Name CLINICA SIERRA VISTA (DBA) FRESNO MOBILE UNIT
Street 2740 S ELM AVE VIN# 1FDNF6AN5PDF01269
City FRESNO
State CA
ZIP 93706
Phone 661 635-3050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Mobile Laboratory
Lab Director FERISHTA GOUSSE

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