05D0616752 CLIA NUMBER - PEACH TREE SACRAMENTO

Laboratory Demographics

  • CLIA Code: 05D0616752
  • Facility Name: PEACH TREE SACRAMENTO
  • Facility Address: 3810 ROSIN COURT
    SACRAMENTO, CA
    ZIP 95834
  • Facility Phone: 916 779-7656
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: RICHARD FURY
  • NPI Number: 1164886040
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0616752
LAB Type Federally Qualified Health Center
Facility Name PEACH TREE SACRAMENTO
Street 3810 ROSIN COURT
City SACRAMENTO
State CA
ZIP 95834
Phone 916 779-7656
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 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Federally Qualified Health Center
Lab Director RICHARD FURY

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