05D1026355 CLIA NUMBER - ANDREW TAK MD

Laboratory Demographics

  • CLIA Code: 05D1026355
  • Facility Name: ANDREW TAK MD
  • Facility Address: 1111 EXPOSITION BLVD BLDG 400A
    SACRAMENTO, CA
    ZIP 95815
  • Facility Phone: 916 646-4583
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDREW J. TAK MD
  • NPI Number: 1528158953
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1026355
LAB Type Physician Office
Facility Name ANDREW TAK MD
Street 1111 EXPOSITION BLVD BLDG 400A
City SACRAMENTO
State CA
ZIP 95815
Phone 916 646-4583
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director ANDREW J. TAK MD

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