05D1013542 CLIA NUMBER - BENEDICTO M ESTOESTA MD

Laboratory Demographics

  • CLIA Code: 05D1013542
  • Facility Name: BENEDICTO M ESTOESTA MD
  • Facility Address: 55 HIGHWAY 26 SUITE #1
    VALLEY SPRINGS, CA
    ZIP 95252
  • Facility Phone: 209 772-8906
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENEDICTO M. ESTOESTA MD
  • NPI Number: 1649451071
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1013542
LAB Type Physician Office
Facility Name BENEDICTO M ESTOESTA MD
Street 55 HIGHWAY 26 SUITE #1
City VALLEY SPRINGS
State CA
ZIP 95252
Phone 209 772-8906
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2025
Certificate Expiration Date 6/10/2027
Facility Type Physician Office
Lab Director BENEDICTO M. ESTOESTA MD

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