05D2289174 CLIA NUMBER - BERKELEY OUTPATIENT ADULT MEDICAL SPECIALTIES

Laboratory Demographics

  • CLIA Code: 05D2289174
  • Facility Name: BERKELEY OUTPATIENT ADULT MEDICAL SPECIALTIES
  • Facility Address: 3100 SAN PABLO AVE SUITE 420
    BERKELEY, CA
    ZIP 94702
  • Facility Phone: 415 353-8628
  • Facility Type: Other - AMBULATORY SITE
  • Facility Type: Microscopy
  • Lab Director: CLIFTON WATT
  • NPI Number: 1598956757
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2289174
LAB Type Other - AMBULATORY SITE
Facility Name BERKELEY OUTPATIENT ADULT MEDICAL SPECIALTIES
Street 3100 SAN PABLO AVE SUITE 420
City BERKELEY
State CA
ZIP 94702
Phone 415 353-8628
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Other - AMBULATORY SITE
Lab Director CLIFTON WATT

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