05D1005714 CLIA NUMBER - JAKKIDI S REDDY MD

Laboratory Demographics

  • CLIA Code: 05D1005714
  • Facility Name: JAKKIDI S REDDY MD
  • Facility Address: 588 N SUNRISE AVE #120
    ROSEVILLE, CA
    ZIP 95661
  • Facility Phone: 916 781-9885
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: REDDY S. JAKKIDI MD
  • NPI Number: 1780760421
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1005714
LAB Type Physician Office
Facility Name JAKKIDI S REDDY MD
Street 588 N SUNRISE AVE #120
City ROSEVILLE
State CA
ZIP 95661
Phone 916 781-9885
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 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Physician Office
Lab Director REDDY S. JAKKIDI MD

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