Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CCRM SAN FRANCISCO, LLC
NPI 1609357169
Clinical Medical Laboratory in Menlo Park, CA

Active since August 23, 2018CLIA 05D2139767 · Accreditation
1060 MARSH RD FL 1, MENLO PARK, CA 94025(650) 646-7500 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 10, 2026, Aug 23, 2018 (2 updates tracked since 2018).

About Ccrm San Francisco, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CCRM SAN FRANCISCO, LLC (NPI 1609357169) is a healthcare organization registered as a clinical medical laboratory in Menlo Park, California and active in the NPI registry since August 2018. The organization holds an CLIA Accreditation certificate valid through November 13, 2026 and lists Matt Tyson, Director, Managed Care Contracting, as its authorized official.

NPPES Registry Identity

NPI1609357169
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameCCRM SAN FRANCISCO, LLC
Location Address1060 MARSH RD FL 1Menlo Park, CA 94025-1020
Mailing Address1060 Marsh Rd Fl 1Menlo Park, CA 94025-1964
Organization SubpartNo
Authorized OfficialMatt TysonDirector, Managed Care Contracting · (615) 477-6677
Enumeration DateAugust 23, 2018
Last NPPES UpdateJuly 10, 20262 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
NPI 1609357169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed · 05D2139767
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
1060 MARSH RD FL 1, Menlo Park, CA 94025

Other Identifiers 1

Other05D2139767Clia

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 05D2139767

Ccrm San Francisco, LLC · Menlo Park, CA
Active · expires Nov 13, 2026
CLIA Number05D2139767
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2024
Certificate Expiration DateNovember 13, 2026
Laboratory DirectorDr. Salli I. Tazuke
Laboratory Phone(734) 645-0119
Laboratory LocationCcrm San Francisco, LLC1060 Marsh Rd, 1st Fl, Menlo Park, CA 94025
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Urology
1060 MARSH RD FL 1
MENLO PARK, CA 94025
Obstetrics & Gynecology (Reproductive Endocrinology)
1060 MARSH RD FL 1
MENLO PARK, CA 94025
Clinic/Center
1060 MARSH RD FL 1
MENLO PARK, CA 94025

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ccrm San Francisco, LLC's NPI number?

The NPI number for Ccrm San Francisco, LLC is 1609357169. It was assigned to this organization in the NPPES registry on August 23, 2018.

Where is Ccrm San Francisco, LLC located?

Ccrm San Francisco, LLC is located at 1060 Marsh Rd Fl 1, Menlo Park, CA 94025. The listed phone number is (650) 646-7500.

What is Ccrm San Francisco, LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Ccrm San Francisco, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 05D2139767) is associated with this NPI, valid through November 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ccrm San Francisco, LLC was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.