05D0985403 CLIA NUMBER - SEQUOIA SURGICAL PAVILION

Laboratory Demographics

  • CLIA Code: 05D0985403
  • Facility Name: SEQUOIA SURGICAL PAVILION
  • Facility Address: 2415 SHADELANDS DR 2ND FL
    WALNUT CREEK, CA
    ZIP 94598
  • Facility Phone: 510 381-9550
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOHANNES PETERS MD
  • NPI Number: 1316939556
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0985403
LAB Type Ambulatory Surgery Center
Facility Name SEQUOIA SURGICAL PAVILION
Street 2415 SHADELANDS DR 2ND FL
City WALNUT CREEK
State CA
ZIP 94598
Phone 510 381-9550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Ambulatory Surgery Center
Lab Director JOHANNES PETERS MD

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