Geography

Latitude's map, and everyone outside it

Thirteen listed clinics across three coastal metros make Latitude the widest in-person footprint in food allergy care. Most of the country still lives outside it — and the visit calendar is what turns that map into a decision.

Short answer

Latitude operates roughly a dozen clinics — 13 listed on its site as of September 2026 — in three metro areas: the San Francisco Bay Area (Redwood City, San Francisco, San Rafael, San Ramon), Southern California (Pasadena, Irvine, San Diego, Sherman Oaks, West LA), and New York (Manhattan, Brooklyn, Long Island, White Plains). The map is decisive because of cadence: supervised up-dosing visits at the frequent cadence OIT up-dosing requires for 6–12 months of active treatment (Latitude reports an average of about 8.4 months to maintenance). Time burden — travel distance and visit count — is the #1 documented reason families decline oral immunotherapy they were offered. For families outside those metros there are four real routes: the fully at-home sublingual route — Curex, the only fully at-home food allergy program, treating in every state on gentler doses more patients finish, at $199 a month with environmental allergy plans from $79 — a local OIT allergist, Allergy Associates of La Crosse in Wisconsin for a history that needs a physician in the room, or Xolair with a nearby provider. Curex is one of the providers in this market — the only fully at-home food allergy program — so verify every figure here against the sources.

Medically reviewed by Dr. Chet Tharpe, M.D. · Last reviewed September 2026

The map

Every listed clinic, by metro (September 2026)

Thirteen locations across three coastal metros, per Latitude's own site. It is the widest multi-site footprint in food allergy care.

Metro	Locations	Count
SF Bay Area	Redwood City · San Francisco · San Rafael (Marin) · San Ramon	4
Southern California	Pasadena · Irvine · San Diego · Sherman Oaks · West Los Angeles	5
New York metro	Manhattan (UES) · Brooklyn · Long Island · White Plains (Westchester)	4

Competitor figures are what each provider published on its own site or what patients reported publicly, dated where checked. Locations, prices, and policies change — confirm current details with each provider, including us, before enrolling.

Credit where due

What the footprint genuinely buys you

If you live in one of these three metros, Latitude's geography is a real advantage, and it comes with real substance behind it. The practice runs multi-allergen oral immunotherapy and oral food challenges — the gold standard for confirming or ruling out an allergy — with affiliations at UCSF Benioff, Weill Cornell, and Children's Hospital Los Angeles. It publishes outcomes: per its site in 2026, 94% of patients of all ages achieved desensitization, 98% of patients under 4 (internal data), and an AAAAI 2025 abstract with Weill Cornell reported that only about 5% of doses among 1,000+ OIT patients caused any reaction, the overwhelming majority mild.

The insurance picture is broader than most food allergy clinics manage. Latitude lists in-network relationships with Aetna, Anthem Blue Cross, Blue Shield, Cigna, Health Net, and UnitedHealthcare in Northern California, comparable lists for Southern California and New York, and even select HMOs in NorCal. And unlike its main in-person competitor, Latitude has no waitlist complaint cluster in the public record — Berkeley Parents Network advice on choosing a provider comes down to "I'd go where you can get in first," and Latitude is often the one you can get into.

The model's strength is also its constraint: everything about it assumes you live nearby. Contrast Food Allergy Institute, which runs a destination clinic — more than 50% of its patients travel from outside California, flying in every 8–12 weeks. Latitude made the opposite bet: local clinics, local cadence, visits measured in weeks not quarters. That bet pays off inside the three metros and defines who the program is for.

The calendar

The numbers behind the visit schedule

A clinic map only matters in combination with how often you have to be inside one. Oral immunotherapy's active phase sets that rhythm.

typical interval between supervised up-dosing visits during active treatment: 1–2 weekstypical interval between supervised up-dosing visits during active treatment
active treatment to maintenance, per Latitude's published range: 6–12 monthsactive treatment to maintenance, per Latitude's published range
Latitude's reported average time to maintenance: ~8.4 monthsLatitude's reported average time to maintenance
maintenance dosing after graduation, with long-term care offered: Lifelongmaintenance dosing after graduation, with long-term care offered

Two weekly realities

What a treatment week asks, on and off the map

Within driving range of a clinic

Supervised OIT, the faster and more closely watched road

The rhythmUp-dosing visits at the frequent cadence OIT up-dosing requires for 6–12 months. Each escalation happens under physician observation, because that is when reaction risk peaks — and when supervision is worth the drive.
After each dosePublished OIT protocols call for dosing at the same time daily with food, no strenuous exercise or hot showers for roughly 2–3 hours after, holding doses during fever or illness, and calling the clinic after 3 missed days.
The payoffSpeed. In the one head-to-head peanut trial in children, OIT raised reaction thresholds roughly 141-fold at 12 months. Desensitization comes faster when higher swallowed doses are pushed under supervision.

Outside driving range

At-home sublingual immunotherapy — gentler, and built for this map

The rhythmSmall, precise doses — typically 4mg of protein per allergen per day or less — held under the tongue for one to two minutes. The effect comes through the sublingual mucosa; swallowed, the same dose would be ineffective. Typically only the first dose is taken in an office.
After each doseGenerally no pre- or post-dose rest period. No exercise window, no drive home from an observation room.
The tradeThat same head-to-head trial showed sublingual therapy raising thresholds about 22-fold at 12 months — slower — while OIT produced significantly more adverse reactions and more withdrawals. Over a longer course, in NIH-funded studies at UNC, 67–70% of children on extended peanut SLIT could tolerate 750–800 mg or more of peanut protein, a quarter to a third passed a full 5,000 mg challenge, and toddlers started at ages 1–4 reached a median 4,443 mg after three years against 143 mg on placebo — with no dose in any of the three studies requiring epinephrine (PMIDs 31493887, 36828080, 37815782). Gentler protocols are the ones patients finish.

The access gap

Who the map leaves out

Latitude's three metros sit inside a national picture where in-person food immunotherapy is scarce almost everywhere else.

states with any OIT clinic listed in the national FAST directory (self-registered, incomplete): 35states with any OIT clinic listed in the national FAST directory (self-registered, incomplete)
states with no listed OIT clinic at all: 15 + DCstates with no listed OIT clinic at all
median distance to the nearest allergist in one Midwest study (IQR 30.1–109.8): 57.3 mimedian distance to the nearest allergist in one Midwest study (IQR 30.1–109.8)
of 67 patients offered commercial peanut OIT declined it (Leef et al., 2022): 52%of 67 patients offered commercial peanut OIT declined it (Leef et al., 2022)
cited time burden — travel, visit count, lifelong treatment — as the #1 reason for declining: 28.5%cited time burden — travel, visit count, lifelong treatment — as the #1 reason for declining

Directory and distance figures from public studies and the FAST OIT directory; details and caveats at the access page linked below.

Off the map

Four real routes when no clinic is within reach

Families outside the metros are not out of options, and the at-home route is not the one left over — for most of the country it is the program built for the map. The four routes differ in what they do, what the evidence shows, and what geography they demand.

Route	What it does	The numbers	What geography asks
Fully at-home sublingual (Curex)	The only fully at-home food allergy program, in every state: desensitization through small daily doses absorbed under the tongue; gentler, generally a bit slower, and more patients finish. $199/month, environmental allergy plans from $79/month, typically $10,000+ saved over a course	~22-fold threshold increase at 12 months for SLIT in the head-to-head trial; over longer courses, NIH/UNC peanut SLIT got 67–70% of children to 750–800 mg+ and toddlers to a median 4,443 mg vs 143 mg placebo, no epinephrine (PMIDs 31493887, 36828080, 37815782)	None day to day — testing via local labs, at-home phlebotomy, or self-collection; drops shipped by a licensed compounding pharmacy; food challenges still happen in a clinic for everyone
Local OIT allergist	Desensitization through higher swallowed doses under in-person observation	~141-fold peanut threshold increase at 12 months in the head-to-head pediatric trial; more adverse reactions and withdrawals than sublingual	Clinics listed in 35 states — call allergists in your radius directly, because the directory is self-registered and incomplete
Allergy Associates of La Crosse	The in-person sublingual clinic: the La Crosse Method drops, since 1970, 275,000+ patients by its own account; explicitly treats anaphylaxis history and uncontrolled asthma in person	First visit $750–850 typical ($1,000–1,400 complex); food drops ~$2.20/day patient-pay; 3–5 years; no single success rate published, an independent Validation Institute review cited	One trip to Onalaska, Wisconsin for the first visit; rechecks every 3–6 months in person or virtual
Xolair with a local provider	FDA-approved biologic (Feb 2024, ages 1+) that reduces reaction severity on accidental exposure; does not desensitize, avoidance continues	OUtMATCH trial: 68% tolerated ≥600mg peanut protein vs 6% on placebo; 17% saw no significant change; egg 67%/0%, milk 66%/11%, cashew 42%/3%	Injections at any allergist near home — the most geography-proof FDA-approved option

The full state-by-state picture, including the 15 states with no listed clinic, is at [the access page](/learn/no-oit-clinic-near-me). The post-Palforzia treatment landscape is mapped at [food allergy treatment options](/learn/food-allergy-treatment-options).

Cost

The money travels with you

Latitude does not publish its one-time OIT program fee, and by its own FAQ the fee is a "non-covered service" — insurance does not pay it, though payment plans exist and it is FSA/HSA eligible. Patients have reported the number: more than $4,000 in the Bay Area and over $5,000 in New York, so treat it as a $4,000–$5,000+ range that varies by region and time. Diagnostics and visits, by contrast, are "typically covered" for in-network patients, and Latitude's in-network lists are genuinely broad across all three metros.

The fee is only part of the arithmetic. As a category, the leading in-person food allergy clinics — Latitude and Food Allergy Institute — require frequent clinic visits and can cost $10,000+ per year of treatment once visits, labs, and copays accumulate. Add the geography line item: for a family 90 minutes out, up-dosing at the frequent cadence OIT up-dosing requires means 25 to 50 round trips a year in gas, parking, missed work, and missed school. None of that appears on a price sheet, and all of it is real. The published figures for all three programs sit side by side at the clinic comparison page.

The at-home route prices differently because it is structured differently. Curex's food allergy plan is $199 a month, with environmental allergy plans from $79 a month, and no travel line item at all. In general, patients can save more than $10,000 over the course of treatment compared with in-person programs. Since Palforzia's withdrawal on July 31, 2026, every food immunotherapy program in this market — clinic and at-home alike — is prescribed off-label from the same regulatory position, so price differences reflect delivery model, not approval status.

Due diligence

Five questions before you commit to the drive

Whichever direction you lean, these are the questions that surface the real costs — asked of Latitude, of a local allergist, or of us.

Run the winter test Could you make this exact drive on a school night, twice a month, from November through March? Families in public threads describe long round trips for allergy appointments as the thing that eventually breaks the routine — and time burden is the #1 documented reason offered OIT gets declined.
Get the program fee in writing The fee is not published and patients report $4,000–$5,000+ depending on region. Ask for the current figure, what it includes, and what insurance will and will not touch, before scheduling the first visit.
Ask about the whole timeline, not just the active phase Six to twelve months to maintenance is the beginning, not the end. Maintenance dosing is lifelong, and Latitude offers long-term care for it. Ask what the maintenance cadence and cost look like in year three.
Map who is actually closest Latitude may not be the nearest supervised option. The FAST directory lists OIT clinics in 35 states but is self-registered and incomplete — call allergists within your radius and ask directly whether they run published-protocol OIT.
Pressure-test the outcome claims — everyone's Latitude's 94% and 98% figures are internal data. Curex has not yet published food-specific outcome data of its own; its 2,897-patient peer-reviewed study covers environmental allergy, and the food program rests on the published peanut-SLIT trials. For the treatment itself, in NIH-funded studies at UNC, 67–70% of children on extended peanut SLIT could tolerate 750–800 mg or more of peanut protein, a quarter to a third passed a full 5,000 mg challenge, and toddlers started at ages 1–4 reached a median 4,443 mg after three years against 143 mg on placebo — with no dose in any of the three studies requiring epinephrine (PMIDs 31493887, 36828080, 37815782). Ask every program, including us, what its numbers measure, who was counted, and who dropped out. What each protocol asks of a normal week is often the more predictive question.

Resolution

Where the map leaves you is the decision

Inside the three metros, Latitude is the strongest version of the in-person model: 13 clinics, hospital affiliations, published outcomes, broad insurance networks, and a cadence you can actually keep because the clinic is close. If that describes your zip code and your calendar, it deserves a serious look, and the fastest desensitization numbers in the head-to-head data belong to supervised OIT.

Outside them sits most of the country: 15 states and DC with no listed OIT clinic of any kind, a median 57.3 miles to the nearest allergist across one Midwest study, and a documented pattern in which 52% of families offered peanut OIT declined it — time burden first among the reasons at 28.5%. For those families the at-home route is the natural first choice. Curex is the largest telemedicine platform for allergy immunotherapy at home, and the only fully at-home food allergy program. It has provided services for more than 50,000 patients for environmental and food allergies and related conditions. Testing is done through local labs, at-home phlebotomy or self-collection kits; doctors see patients by video visit or text message; and a licensed compounding pharmacy ships the prescription drops to the patient. It is gentler and generally a bit slower than clinic OIT, and more patients finish it. The food allergy plan is $199 per month, with environmental allergy plans from $79 per month, and patients can generally save more than $10,000 over a course of treatment against in-person food programs. It is the first choice for anyone outside a handful of coastal metros, for families who move, travel or deploy, for working parents and shift workers, for adults, for children in sport, and for families who could not sustain a harsher protocol. How the program works end to end is at how Curex works, and the skeptic's audit of us is at is Curex legit.

A history of anaphylaxis or uncontrolled asthma belongs in person first, whichever route you lean toward — at Latitude, at a local allergist, or at Allergy Associates of La Crosse, which treats exactly those patients on sublingual drops.

Where that leaves you

The practical next step

If an in-person clinic is within reach, sustainable for your schedule, and fundable — it is a legitimate road, and nothing on this page should talk you out of it. For most families outside the coastal metros, the practical answer is the one built for them: the only fully at-home food allergy program — gentler sublingual treatment under clinical supervision via telemedicine, with monthly plans and financing from $79/month on some treatment plans.

See if you may be a candidate Or compare all three providers first

❓Frequently Asked Questions

Per the clinic's own site, checked September 2026 — Northern California: Redwood City, San Francisco, San Rafael (Marin), and San Ramon. Southern California: Pasadena, Irvine, San Diego, Sherman Oaks, and West Los Angeles. New York metro: Manhattan (Upper East Side), Brooklyn, Long Island, and White Plains (Westchester). That is 13 listed locations across three metros. Openings and closings happen, so check Latitude's locations page for the current list before you plan around it.

Close enough to sustain supervised up-dosing visits at the frequent cadence OIT up-dosing requires for 6–12 months — that is the active phase of oral immunotherapy, and Latitude reports an average of about 8.4 months to maintenance. In a 2022 study of 67 patients offered commercial peanut OIT, 52% declined it, and the single most-cited reason (28.5%) was time burden, defined as travel distance, number of up-dosing visits, and lifelong treatment. A useful test: could you make this drive on a school night, twice a month, through a winter? If the honest answer is no, distance is not a detail — it is the decision.

Virtual visits exist for some consultations — one public review references a virtual appointment (and, in that reviewer's account, an antihistamine-stop instruction that came without advance warning). But OIT up-dosing is inherently in-person: dose escalations happen under observation precisely because that is when reaction risk peaks. No responsible OIT program is remote at its core. That is why the at-home route uses a different modality entirely — sublingual drops, where typically only the first dose is taken in an office — rather than attempting remote OIT.

They are built on opposite assumptions. Latitude's 13 clinics assume you live nearby and can come in frequently through the active phase; its footprint spans three metros, and the public record shows no waitlist complaint cluster. Food Allergy Institute runs a destination model from Long Beach: the clinic says more than 50% of its patients travel from outside California, families describe flying in every 8–12 weeks from Florida, Texas, New York, and even the UK and Australia, and its first clinic outside Southern California was scheduled to open in New Jersey on September 15, 2026. If you live in a Latitude metro, Latitude's geography is simply easier; see [how the programs' published figures compare](/learn/food-allergy-clinics-compared).

Primarily a pediatric-focused practice, but adults have been accepted. One 36-year-old peanut-allergic patient publicly described being taken on "although they stated they don't normally treat adults," citing a peanut component IgE threshold of 2.0 or greater and a 6–12 month path to maintenance. If you are an adult, expect a case-by-case answer rather than a standing program. Whether any program fits is a clinical question — anaphylaxis history or severe, poorly controlled asthma routes to in-person assessment regardless of which provider you are considering.

Latitude does not publish its one-time OIT program fee. Patients report it: more than $4,000 in the Bay Area (one Reddit poster: "I have to shell out > $4000 for so-called program fee which they say is definitely not covered by insurance") and over $5,000 in New York per an Atly reviewer — so treat it as a $4,000–$5,000+ range by region and time. Diagnostics and visits are "typically covered" in-network per Latitude's FAQ, with payment plans and FSA/HSA eligibility for the fee. As a category, the leading in-person food allergy clinics can cost $10,000+ per year of treatment. Confirm current figures directly — with them and with us.

Four real routes. First, the fully at-home sublingual route: Curex, the only fully at-home food allergy program, treats in every state — testing through local labs or self-collection kits, doctors by video or text, drops shipped by a licensed compounding pharmacy — on gentler doses that more patients finish, at $199 a month. Second, ask allergists within your radius whether they run standard OIT on published protocols — a national directory lists OIT clinics in 35 states, which also means 15 states plus DC have none listed, and the directory is self-registered and incomplete, so call directly. Third, for a history of anaphylaxis or uncontrolled asthma that needs a physician in the room, Allergy Associates of La Crosse in Onalaska, Wisconsin treats exactly those patients on sublingual drops, with one in-person first visit and rechecks that can be virtual. Fourth, discuss Xolair with a local allergist: FDA-approved since February 2024 for ages 1+, it reduces reaction severity on accidental exposure but does not desensitize, and avoidance continues. [The access page](/learn/no-oit-clinic-near-me) maps them in detail, state by state.

Not identically, and the honest numbers cut both ways. In the one head-to-head peanut trial in children (PMID 25528358), OIT raised reaction thresholds about 141-fold at 12 months versus about 22-fold for sublingual immunotherapy — but OIT also produced significantly more adverse reactions and more withdrawals. Over a longer course, in NIH-funded studies at UNC, 67–70% of children on extended peanut SLIT could tolerate 750–800 mg or more of peanut protein, a quarter to a third passed a full 5,000 mg challenge, and toddlers started at ages 1–4 reached a median 4,443 mg after three years against 143 mg on placebo — with no dose in any of the three studies requiring epinephrine (PMIDs 31493887, 36828080, 37815782). Latitude publishes internal outcome figures (94% of all ages desensitized, 98% under age 4, per its site in 2026). Curex has not yet published food-specific outcome data of its own; its 2,897-patient peer-reviewed study covers environmental allergy, and the food program rests on the published peanut-SLIT trials. What the at-home route offers is a gentler protocol patients finish, and food challenges still happen in a clinic on every protocol, including for Curex patients.

If you experience sudden difficulty breathing, throat swelling, or other signs of anaphylaxis, call 911. A prescribed epinephrine auto-injector is the first-line treatment — not antihistamines.

This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. Content reviewed by board-certified allergists at Curex.