05D1003000 CLIA NUMBER - SIERRA PACIFIC ORTHOPAEDIC CENTER MED GROUP INC

Laboratory Demographics

  • CLIA Code: 05D1003000
  • Facility Name: SIERRA PACIFIC ORTHOPAEDIC CENTER MED GROUP INC
  • Facility Address: 1630 E HERNDON AVE
    FRESNO, CA
    ZIP 93720
  • Facility Phone: 559 256-5200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RODNEY S. KRAFT
  • NPI Number: 1134583578
  • Taxonomy: 2251X0800X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 05D1003000
LAB Type Physician Office
Facility Name SIERRA PACIFIC ORTHOPAEDIC CENTER MED GROUP INC
Street 1630 E HERNDON AVE
City FRESNO
State CA
ZIP 93720
Phone 559 256-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Physician Office
Lab Director DR. RODNEY S. KRAFT

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