05D0867567 CLIA NUMBER - NEVA MONIGATTI-LAKE MD

Laboratory Demographics

  • CLIA Code: 05D0867567
  • Facility Name: NEVA MONIGATTI-LAKE MD
  • Facility Address: 300 SIERRA COLLEGE DR SUITE 170
    GRASS VALLEY, CA
    ZIP 95945
  • Facility Phone: 916 273-4376
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: NEVA M. MONIGATTI-LAKE
  • NPI Number: 1740477587
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0867567
LAB Type Physician Office
Facility Name NEVA MONIGATTI-LAKE MD
Street 300 SIERRA COLLEGE DR SUITE 170
City GRASS VALLEY
State CA
ZIP 95945
Phone 916 273-4376
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 NEVA M. MONIGATTI-LAKE

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