05D0617011 CLIA NUMBER - TADD L SELBY, MD

Laboratory Demographics

  • CLIA Code: 05D0617011
  • Facility Name: TADD L SELBY, MD
  • Facility Address: 1166 ESPLANADE SUITE 3
    CHICO, CA
    ZIP 95926
  • Facility Phone: 916 893-0771
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TADD L. SELBY MD
  • NPI Number: 1699700377
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 05D0617011
LAB Type Physician Office
Facility Name TADD L SELBY, MD
Street 1166 ESPLANADE SUITE 3
City CHICO
State CA
ZIP 95926
Phone 916 893-0771
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director TADD L. SELBY MD

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