05D0920511 CLIA NUMBER - SIERRA NEVADA GASTROENTEROLOGY MEDICAL ASSOCIATES INC

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Laboratory Demographics

CLIA Number: 05D0920511

Facility Name: SIERRA NEVADA GASTROENTEROLOGY MEDICAL ASSOCIATES INC

Facility Address:
300 SIERRA COLLEGE DR STE 220
GRASS VALLEY, CA
ZIP 95945
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Facility Phone Number: 530 273-3377

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1407928641

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	05D0920511
LAB Type	Physician Office
Facility Name	SIERRA NEVADA GASTROENTEROLOGY MEDICAL ASSOCIATES INC
Street	300 SIERRA COLLEGE DR STE 220
City	GRASS VALLEY
State	CA
ZIP	95945
Phone	530 273-3377
CertificateType	2
CertificateEffectiveDate	4/6/2022
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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