05D0601225 CLIA NUMBER - NORTH BAY PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D0601225
  • Facility Name: NORTH BAY PEDIATRICS
  • Facility Address: 160 GLEN COVE MARINA RD STE 103
    VALLEJO, CA
    ZIP 94591
  • Facility Phone: 707 648-0711
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANEE F. MARTIN
  • NPI Number: 1932132297
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0601225
LAB Type Physician Office
Facility Name NORTH BAY PEDIATRICS
Street 160 GLEN COVE MARINA RD STE 103
City VALLEJO
State CA
ZIP 94591
Phone 707 648-0711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Physician Office
Lab Director SHANEE F. MARTIN

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