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

Laboratory Demographics

  • CLIA Code: 05D0904610
  • Facility Name: BRUCE R CARLTON, MD, INC
  • Facility Address: 292 ALAMO SUITE 2
    VACAVILLE, CA
    ZIP 95688
  • Facility Phone: 707 448-2218
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRUCE R. CARLTON
  • NPI Number: 1093802589
  • Taxonomy: 174400000X - Specialist

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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
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 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Physician Office
Lab Director BRUCE R. CARLTON

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