05D0599552 CLIA NUMBER - HEALTH SERVICES FOUNDATION LABORATORY

Laboratory Demographics

  • CLIA Code: 05D0599552
  • Facility Name: HEALTH SERVICES FOUNDATION LABORATORY
  • Facility Address: 16960 S HARLAN RD STE 2
    LATHROP, CA
    ZIP 95330
  • Facility Phone: 209 825-1362
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JERRY REEVES
  • NPI Number: 1104403864
  • Taxonomy: 164X00000X - Licensed Vocational Nurse

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CLIA Record

Field Name Field Value
CLIA Number 05D0599552
LAB Type Mobile Laboratory
Facility Name HEALTH SERVICES FOUNDATION LABORATORY
Street 16960 S HARLAN RD STE 2
City LATHROP
State CA
ZIP 95330
Phone 209 825-1362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Mobile Laboratory
Lab Director JERRY REEVES

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This page was last updated on: 3/20/2025