05D0708005 CLIA NUMBER - WINDSOR ELK GROVE CARE AND REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 05D0708005
  • Facility Name: WINDSOR ELK GROVE CARE AND REHABILITATION CENTER
  • Facility Address: 9461 BATEY AVENUE
    ELK GROVE, CA
    ZIP 95624
  • Facility Phone: 916 685-9525
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LARRY FELICIANO
  • NPI Number: 1265451348
  • Taxonomy: 332BP3500X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 05D0708005
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WINDSOR ELK GROVE CARE AND REHABILITATION CENTER
Street 9461 BATEY AVENUE
City ELK GROVE
State CA
ZIP 95624
Phone 916 685-9525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LARRY FELICIANO

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