05D0970707 CLIA NUMBER - RAGHUNATH K REDDY MD

Laboratory Demographics

CLIA Number: 05D0970707

Facility Name: RAGHUNATH K REDDY MD

Facility Address:
1805 W CALIFORNIA ST #102
STOCKTON, CA
ZIP 95204
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Facility Phone Number: 209 946-4000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689775819

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0970707
LAB Type	Physician Office
Facility Name	RAGHUNATH K REDDY MD
Street	1805 W CALIFORNIA ST #102
City	STOCKTON
State	CA
ZIP	95204
Phone	209 946-4000
CertificateType	4
CertificateEffectiveDate	2/23/2024
CertificateExpirationDate	2/22/2026
FacilityType	Waiver

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