05D0991196 CLIA NUMBER - SIERRA NEVADA PRIMARY CARE PHYSICIANS

Laboratory Demographics

  • CLIA Code: 05D0991196
  • Facility Name: SIERRA NEVADA PRIMARY CARE PHYSICIANS
  • Facility Address: 11400 PLEASANT VALLEY ROAD
    PENN VALLEY, CA
    ZIP 95946
  • Facility Phone: 530 477-4016
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARA BEREZNIAK DO
  • NPI Number: 1235145608
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0991196
LAB Type Physician Office
Facility Name SIERRA NEVADA PRIMARY CARE PHYSICIANS
Street 11400 PLEASANT VALLEY ROAD
City PENN VALLEY
State CA
ZIP 95946
Phone 530 477-4016
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 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Physician Office
Lab Director MARA BEREZNIAK DO

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