05D2299083 CLIA NUMBER - AGILE OCCUPATIONAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 05D2299083
  • Facility Name: AGILE OCCUPATIONAL MEDICINE, PC
  • Facility Address: 2524 H DELA ROSA SR STREET
    SOLEDAD, CA
    ZIP 93960
  • Facility Phone: 760 828-5681
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINH NGUYEN
  • NPI Number: 1356033278
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2299083
LAB Type Physician Office
Facility Name AGILE OCCUPATIONAL MEDICINE, PC
Street 2524 H DELA ROSA SR STREET
City SOLEDAD
State CA
ZIP 93960
Phone 760 828-5681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Physician Office
Lab Director MINH NGUYEN

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