05D0904610 CLIA NUMBER - BRUCE R CARLTON, MD, INC

Laboratory Demographics

CLIA Number: 05D0904610

Facility Name: BRUCE R CARLTON, MD, INC

Facility Address:
292 ALAMO SUITE 2
VACAVILLE, CA
ZIP 95688
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Facility Phone Number: 707 448-2218

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1093802589

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0904610
LAB Type	Physician Office
Facility Name	BRUCE R CARLTON, MD, INC
Street	292 ALAMO SUITE 2
City	VACAVILLE
State	CA
ZIP	95688
Phone	707 448-2218
CertificateType	3
CertificateEffectiveDate	8/23/2023
CertificateExpirationDate	8/22/2025
FacilityType	PPMP

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