05D0684421 CLIA NUMBER - SUTTER GOULD MEDICAL FOUNDATION - LODI FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 05D0684421
  • Facility Name: SUTTER GOULD MEDICAL FOUNDATION - LODI FAMILY MEDICINE
  • Facility Address: 1300 WEST LODI AVENUE STE P
    LODI, CA
    ZIP 95242
  • Facility Phone: 209 988-3294
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD W. YEE, DO
  • NPI Number: 1063468106
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0684421
LAB Type Physician Office
Facility Name SUTTER GOULD MEDICAL FOUNDATION - LODI FAMILY MEDICINE
Street 1300 WEST LODI AVENUE STE P
City LODI
State CA
ZIP 95242
Phone 209 988-3294
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Physician Office
Lab Director RICHARD W. YEE, DO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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