05D0716355 CLIA NUMBER - SACRAMENTO MIDTOWN ENDOSCOPY CENTER

Laboratory Demographics

CLIA Number: 05D0716355

Facility Name: SACRAMENTO MIDTOWN ENDOSCOPY CENTER

Facility Address:
3941 J ST 460
SACRAMENTO, CA
ZIP 95819
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Facility Phone Number: 916 733-6940

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1730563610

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0716355
LAB Type	Ambulatory Surgery Center
Facility Name	SACRAMENTO MIDTOWN ENDOSCOPY CENTER
Street	3941 J ST 460
City	SACRAMENTO
State	CA
ZIP	95819
Phone	916 733-6940
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024