05D0614782 CLIA NUMBER - NORTHBAY HEALTHCARE GROUP CENTER FOR PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 05D0614782
  • Facility Name: NORTHBAY HEALTHCARE GROUP CENTER FOR PRIMARY CARE
  • Facility Address: 421 NUT TREE RD
    VACAVILLE, CA
    ZIP 95687
  • Facility Phone: 707 624-7533
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: ALI HASSANI MD
  • NPI Number: 1003015843
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0614782
LAB Type Practitioner Other
Facility Name NORTHBAY HEALTHCARE GROUP CENTER FOR PRIMARY CARE
Street 421 NUT TREE RD
City VACAVILLE
State CA
ZIP 95687
Phone 707 624-7533
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 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Practitioner Other
Lab Director ALI HASSANI MD

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