05D1020429 CLIA NUMBER - SUMMIT NEPHROLOGY MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D1020429
  • Facility Name: SUMMIT NEPHROLOGY MEDICAL GROUP INC
  • Facility Address: 151 N SUNRISE AVE STE 1205
    ROSEVILLE, CA
    ZIP 95661
  • Facility Phone: 916 789-1505
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ADARSH BHAT, MD
  • NPI Number: 1962575449
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1020429
LAB Type Physician Office
Facility Name SUMMIT NEPHROLOGY MEDICAL GROUP INC
Street 151 N SUNRISE AVE STE 1205
City ROSEVILLE
State CA
ZIP 95661
Phone 916 789-1505
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 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Physician Office
Lab Director ADARSH BHAT, MD

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