05D0982443 CLIA NUMBER - TRACY URGENT CARE MEDICAL CLINIC INC

Laboratory Demographics

  • CLIA Code: 05D0982443
  • Facility Name: TRACY URGENT CARE MEDICAL CLINIC INC
  • Facility Address: 2160 W GRANT LINE RD STE 230
    TRACY, CA
    ZIP 95377
  • Facility Phone: 209 832-8700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KANWARDEEP S. GREWAL
  • NPI Number: 1265453872
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0982443
LAB Type Physician Office
Facility Name TRACY URGENT CARE MEDICAL CLINIC INC
Street 2160 W GRANT LINE RD STE 230
City TRACY
State CA
ZIP 95377
Phone 209 832-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2024
Certificate Expiration Date 10/8/2026
Facility Type Physician Office
Lab Director KANWARDEEP S. GREWAL

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