05D0894431 CLIA NUMBER - UC DAVIS MEDICAL GROUP FOLSOM

Laboratory Demographics

  • CLIA Code: 05D0894431
  • Facility Name: UC DAVIS MEDICAL GROUP FOLSOM
  • Facility Address: 1370 PRAIRIE CITY RD
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 916 985-9350
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VICTOR H. BAQUERO
  • NPI Number: 1003896648
  • Taxonomy: 261QM1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0894431
LAB Type Physician Office
Facility Name UC DAVIS MEDICAL GROUP FOLSOM
Street 1370 PRAIRIE CITY RD
City FOLSOM
State CA
ZIP 95630
Phone 916 985-9350
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 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director VICTOR H. BAQUERO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025