05D0896465 CLIA NUMBER - TRACY CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0896465
  • Facility Name: TRACY CONVALESCENT HOSPITAL
  • Facility Address: 545 WEST BEVERLY PLACE
    TRACY, CA
    ZIP 95376
  • Facility Phone: 209 835-6034
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ELIZABETH BURKE
  • NPI Number: 1346337896
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0896465
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name TRACY CONVALESCENT HOSPITAL
Street 545 WEST BEVERLY PLACE
City TRACY
State CA
ZIP 95376
Phone 209 835-6034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ELIZABETH BURKE

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