05D0910668 CLIA NUMBER - SAC HEALTH SYSTEM

Laboratory Demographics

  • CLIA Code: 05D0910668
  • Facility Name: SAC HEALTH SYSTEM
  • Facility Address: 1454 E 2ND STREET
    SAN BERNARDINO, CA
    ZIP 92408
  • Facility Phone: 909 382-7100
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DAVID C. AHAMBA
  • NPI Number: 1164045522
  • Taxonomy: 261QF0400X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0910668
LAB Type Federally Qualified Health Center
Facility Name SAC HEALTH SYSTEM
Street 1454 E 2ND STREET
City SAN BERNARDINO
State CA
ZIP 92408
Phone 909 382-7100
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 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Federally Qualified Health Center
Lab Director DAVID C. AHAMBA

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: 9/29/2025