05D0615761 CLIA NUMBER - GOLDEN STATE DERMATOLOGY ASSOCIATES INC - SACRAMENTO

Laboratory Demographics

  • CLIA Code: 05D0615761
  • Facility Name: GOLDEN STATE DERMATOLOGY ASSOCIATES INC - SACRAMENTO
  • Facility Address: 5601 J ST
    SACRAMENTO, CA
    ZIP 95819
  • Facility Phone: 916 454-5922
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: EMIL A. TANGHETTI MD
  • NPI Number: 1043250145
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0615761
LAB Type Physician Office
Facility Name GOLDEN STATE DERMATOLOGY ASSOCIATES INC - SACRAMENTO
Street 5601 J ST
City SACRAMENTO
State CA
ZIP 95819
Phone 916 454-5922
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 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Physician Office
Lab Director EMIL A. TANGHETTI MD

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