05D2289551 CLIA NUMBER - VALLEY ADVANTAGE MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D2289551
  • Facility Name: VALLEY ADVANTAGE MEDICAL GROUP INC
  • Facility Address: 1569 LEXANN AVE STE 124
    SAN JOSE, CA
    ZIP 95121
  • Facility Phone: 408 298-6706
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAM H. NGUYEN
  • NPI Number: 1831434190
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 05D2289551
LAB Type Physician Office
Facility Name VALLEY ADVANTAGE MEDICAL GROUP INC
Street 1569 LEXANN AVE STE 124
City SAN JOSE
State CA
ZIP 95121
Phone 408 298-6706
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Physician Office
Lab Director TAM H. NGUYEN

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