05D2306717 CLIA NUMBER - ADVANCED PRIMARY CARE A DIVISION OF BASS MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D2306717
  • Facility Name: ADVANCED PRIMARY CARE A DIVISION OF BASS MEDICAL GROUP
  • Facility Address: 175 N JACKSON AVE STE 200
    SAN JOSE, CA
    ZIP 95116
  • Facility Phone: 209 208-0643
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TANVI RAMAN
  • NPI Number: 1043345051
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 05D2306717
LAB Type Physician Office
Facility Name ADVANCED PRIMARY CARE A DIVISION OF BASS MEDICAL GROUP
Street 175 N JACKSON AVE STE 200
City SAN JOSE
State CA
ZIP 95116
Phone 209 208-0643
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director TANVI RAMAN

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