05D0712676 CLIA NUMBER - PINE CREEK CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0712676
  • Facility Name: PINE CREEK CARE CENTER
  • Facility Address: 1139 CIRBY WAY
    ROSEVILLE, CA
    ZIP 95661
  • Facility Phone: 916 782-7007
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHANDAN CHEEMA, MD
  • NPI Number: 1437457645
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0712676
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PINE CREEK CARE CENTER
Street 1139 CIRBY WAY
City ROSEVILLE
State CA
ZIP 95661
Phone 916 782-7007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHANDAN CHEEMA, MD

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