05D0890890 CLIA NUMBER - SACRAMENTO PEDIATRICS MEDICAL CORP

Laboratory Demographics

  • CLIA Code: 05D0890890
  • Facility Name: SACRAMENTO PEDIATRICS MEDICAL CORP
  • Facility Address: 7601 HOSPITAL DRIVE SUITE 100A
    SACRAMENTO, CA
    ZIP 95823
  • Facility Phone: 916 682-7841
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. STEPHANIE WALTON
  • NPI Number: 1508361783
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 05D0890890
LAB Type Physician Office
Facility Name SACRAMENTO PEDIATRICS MEDICAL CORP
Street 7601 HOSPITAL DRIVE SUITE 100A
City SACRAMENTO
State CA
ZIP 95823
Phone 916 682-7841
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Physician Office
Lab Director DR. STEPHANIE WALTON

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