05D1036653 CLIA NUMBER - SUTTER AMADOR SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D1036653
  • Facility Name: SUTTER AMADOR SURGERY CENTER, LLC
  • Facility Address: 223 CLINTON RD STE 204
    JACKSON, CA
    ZIP 95642
  • Facility Phone: 209 223-5938
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROBERT M. JARKA
  • NPI Number: 1033453311
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1036653
LAB Type Ambulatory Surgery Center
Facility Name SUTTER AMADOR SURGERY CENTER, LLC
Street 223 CLINTON RD STE 204
City JACKSON
State CA
ZIP 95642
Phone 209 223-5938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Ambulatory Surgery Center
Lab Director ROBERT M. JARKA

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