05D0600996 CLIA NUMBER - TRI-VALLEY PEDIATRIC MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0600996
  • Facility Name: TRI-VALLEY PEDIATRIC MEDICAL GROUP INC
  • Facility Address: 5565 WEST LAS POSITAS BOULEVARD, SUITE #240
    PLEASANTON, CA
    ZIP 94588
  • Facility Phone: 925 460-8444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAM A. PEJHAM MD
  • NPI Number: 1881778546
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0600996
LAB Type Physician Office
Facility Name TRI-VALLEY PEDIATRIC MEDICAL GROUP INC
Street 5565 WEST LAS POSITAS BOULEVARD, SUITE #240
City PLEASANTON
State CA
ZIP 94588
Phone 925 460-8444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Physician Office
Lab Director SAM A. PEJHAM MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025