05D0614501 CLIA NUMBER - MARSHALL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D0614501
  • Facility Name: MARSHALL PEDIATRICS
  • Facility Address: 4341 GOLDEN CENTER DR STE A
    PLACERVILLE, CA
    ZIP 95667
  • Facility Phone: 530 626-1144
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRETT CHRISTIANSEN
  • NPI Number: 1699829184
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0614501
LAB Type Physician Office
Facility Name MARSHALL PEDIATRICS
Street 4341 GOLDEN CENTER DR STE A
City PLACERVILLE
State CA
ZIP 95667
Phone 530 626-1144
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 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director BRETT CHRISTIANSEN

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