Phlebotomy Technician Field Services

PublicHealth

This certificate or a duplicate Change of Name or Address:

thereof, must be conspicuously You are required to notify this office in

* *, ******* ****** ** days of any change in

displayed at each place where your name or address. You may do so by

you practice updating your online profile. Log on to

your account at: www.cdph.ca.gov/LFS

(Go to Cinical Laboratory Personnel section)

PublicHeaith

Contfied Phlebotomy Technician

Service provided by:

California Department of Public Health

Laboratory Field Services

Phone: 510-***-****

E-mail: *****@****.**.***

Van Ng

cPT-02189503

[PRINTING INSTRUCTIONS: To print the standard

Card size (85 60mm 53 98mm), use ‘Actual Siz.”

DO NOT "FIT" TO PAGE.

VERIFY THIS LICENSE

worw.cdph.ca.goviLFS

~ cS

PublicHealth

Certified Phlebotomy Technician

THIS LICENSE IS ISSUED PURSUANT TO DIVISION 2, CHAPTER 3 OF THE CALIFORNIA

BUSINESS AND PROFESSIONS CODE, TO AUTHORIZE

Van Nguyen

TO ENGAGE IN GLINIGAL [ABORATORY PRACTICE ACCORDING TO THE CALIFORNIA CLINICAL

LABORATORY PHLEBOTOMY LAWS AND REGULATIONS.

LICENSE NUMBER

SER STARTDATE: ——June09, 2021

Sa4kt EXPIRATION DATE: June 08, 2023

Kabat 9 Horas.

VERIFY THIS UCENSE. OR VISIT wie cdph ca. gow FS

BRANCH CHEF

LABORATORY ILD SERVICES,

Contact this candidate