05D1057049 CLIA NUMBER - LA CLINICA VALLEJO GREAT BEGINNINGS

Laboratory Demographics

  • CLIA Code: 05D1057049
  • Facility Name: LA CLINICA VALLEJO GREAT BEGINNINGS
  • Facility Address: 210 HOSPITAL DR
    VALLEJO, CA
    ZIP 94589
  • Facility Phone: 707 645-7316
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DR. RYANN MILNE-PRICE
  • NPI Number: 1992863096
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1057049
LAB Type Federally Qualified Health Center
Facility Name LA CLINICA VALLEJO GREAT BEGINNINGS
Street 210 HOSPITAL DR
City VALLEJO
State CA
ZIP 94589
Phone 707 645-7316
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 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Federally Qualified Health Center
Lab Director DR. RYANN MILNE-PRICE

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