05D0614456 CLIA NUMBER - MARSHALL FAMILY MEDICINE-PLACERVILLE

Laboratory Demographics

  • CLIA Code: 05D0614456
  • Facility Name: MARSHALL FAMILY MEDICINE-PLACERVILLE
  • Facility Address: 1095 MARSHALL WAY
    PLACERVILLE, CA
    ZIP 95667
  • Facility Phone: 530 626-2920
  • Facility Type: Other - OUTPATIENT CLINIC
  • Facility Type: Microscopy
  • Lab Director: GERARDO GALANG
  • NPI Number: 1871697904
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0614456
LAB Type Other - OUTPATIENT CLINIC
Facility Name MARSHALL FAMILY MEDICINE-PLACERVILLE
Street 1095 MARSHALL WAY
City PLACERVILLE
State CA
ZIP 95667
Phone 530 626-2920
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Other - OUTPATIENT CLINIC
Lab Director GERARDO GALANG

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