05D0947246 CLIA NUMBER - SYCAMORE MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D0947246
  • Facility Name: SYCAMORE MEDICAL GROUP INC
  • Facility Address: 500 ALFRED NOBEL DRIVE SUITE 150
    HERCULES, CA
    ZIP 94547
  • Facility Phone: 510 741-2111
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARIA C. ESCALADA, MD
  • NPI Number: 1487969028
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D0947246
LAB Type Physician Office
Facility Name SYCAMORE MEDICAL GROUP INC
Street 500 ALFRED NOBEL DRIVE SUITE 150
City HERCULES
State CA
ZIP 94547
Phone 510 741-2111
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 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Physician Office
Lab Director MARIA C. ESCALADA, MD

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