05D2329907 CLIA NUMBER - AFFECTION HEALTH CARE

Laboratory Demographics

  • CLIA Code: 05D2329907
  • Facility Name: AFFECTION HEALTH CARE
  • Facility Address: 1620 N CARPENTER RD UNIT D46
    MODESTO, CA
    ZIP 95351
  • Facility Phone: 350 216-5774
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SOUMIYA PRAKASAM
  • NPI Number: 1710773908
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 05D2329907
LAB Type Physician Office
Facility Name AFFECTION HEALTH CARE
Street 1620 N CARPENTER RD UNIT D46
City MODESTO
State CA
ZIP 95351
Phone 350 216-5774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Physician Office
Lab Director SOUMIYA PRAKASAM

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