05D2299115 CLIA NUMBER - AGILE OCCUPATIONAL MEDICINE

Laboratory Demographics

  • CLIA Code: 05D2299115
  • Facility Name: AGILE OCCUPATIONAL MEDICINE
  • Facility Address: 80 GRAND AVENUE SUITE 500
    OAKLAND, CA
    ZIP 94612
  • Facility Phone: 760 828-5681
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINH NGUYEN DO
  • NPI Number: 1255056149
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2299115
LAB Type Physician Office
Facility Name AGILE OCCUPATIONAL MEDICINE
Street 80 GRAND AVENUE SUITE 500
City OAKLAND
State CA
ZIP 94612
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 DO

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