05D2304336 CLIA NUMBER - AVITA MD

Laboratory Demographics

  • CLIA Code: 05D2304336
  • Facility Name: AVITA MD
  • Facility Address: 525 SOUTH DRIVE, STE 211
    MOUNTAIN VIEW, CA
    ZIP 94040
  • Facility Phone: 408 495-5770
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICIA SITNITSKY
  • NPI Number: 1265121669
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2304336
LAB Type Physician Office
Facility Name AVITA MD
Street 525 SOUTH DRIVE, STE 211
City MOUNTAIN VIEW
State CA
ZIP 94040
Phone 408 495-5770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Physician Office
Lab Director PATRICIA SITNITSKY

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