05D1059296 CLIA NUMBER - DOUGLAS W ANKROM, MD

Laboratory Demographics

  • CLIA Code: 05D1059296
  • Facility Name: DOUGLAS W ANKROM, MD
  • Facility Address: 680 GUZZI LANE, STE 205
    SONORA, CA
    ZIP 95370
  • Facility Phone: 209 533-3321
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS W. ANKROM
  • NPI Number: 1558390393
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 05D1059296
LAB Type Physician Office
Facility Name DOUGLAS W ANKROM, MD
Street 680 GUZZI LANE, STE 205
City SONORA
State CA
ZIP 95370
Phone 209 533-3321
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Physician Office
Lab Director DOUGLAS W. ANKROM

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