05D1019486 CLIA NUMBER - EATON PEDIATRICS AND MEDICAL CORP

Laboratory Demographics

  • CLIA Code: 05D1019486
  • Facility Name: EATON PEDIATRICS AND MEDICAL CORP
  • Facility Address: 518 W EATON AVE
    TRACY, CA
    ZIP 95376
  • Facility Phone: 209 833-2228
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANUEL R. DE LA CRUZ
  • NPI Number: 1336249713
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D1019486
LAB Type Physician Office
Facility Name EATON PEDIATRICS AND MEDICAL CORP
Street 518 W EATON AVE
City TRACY
State CA
ZIP 95376
Phone 209 833-2228
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director MANUEL R. DE LA CRUZ

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