CARBON HEALTH SOUTH BAY MEDICAL GROUP PC
NPI 1740990597
Clinic/Center - Urgent Care in San Jose, CA
- Organization
- Clinic/Center
- Urgent Care
- CLIA Number: 05D2279767
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-05-2027
About CARBON HEALTH SOUTH BAY MEDICAL GROUP PC
This page provides the complete NPI Profile along with additional information for Carbon Health South Bay Medical Group Pc, a provider established in San Jose, California operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1740990597 assigned on December 2022. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Kaitlin Boyle (Director)
- NPI
- 1740990597 Verify this NPI
- Provider Name
- CARBON HEALTH SOUTH BAY MEDICAL GROUP PC
- Entity Type
- Organization
- Location Address
- 377 SANTANA ROW STE 1180 SAN JOSE, CA 95128
- Location Phone
- (669) 247-4773
- Location Fax
- (888) 972-1912
- Mailing Address
- 2100 FRANKLIN ST STE 355 OAKLAND, CA 94612
- Mailing Phone
- (844) 234-7741
- Mailing Fax
- (888) 972-1912
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-02-2022
- Last Update Date
- 07-16-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2279767
- Facility Type
- Physician Office
- Certificate Effective Date
- April 06, 2025
- Certificate Expiration Date
- April 05, 2027
- Laboratory Director
- SUJAL MANDAVIA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Carbon Health South Bay Medical Group Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
SAN JOSE, CA 95128
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1740990597, enumerated as an "organization" on December 02, 2022.
The provider is located at 377 SANTANA ROW STE 1180 SAN JOSE, CA 95128 and the phone number is (669) 247-4773.
Clinic/Center with taxonomy code 261QU0200X and a focus in Urgent Care.
