05D1071434 CLIA NUMBER - TRI-RIVER PEDIATRIC

Laboratory Demographics

  • CLIA Code: 05D1071434
  • Facility Name: TRI-RIVER PEDIATRIC
  • Facility Address: 7260 E SOUTHGATE DR STE #D
    SACRAMENTO, CA
    ZIP 95823
  • Facility Phone: 916 428-7990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICKI P. DUONG
  • NPI Number: 1861092868
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1071434
LAB Type Physician Office
Facility Name TRI-RIVER PEDIATRIC
Street 7260 E SOUTHGATE DR STE #D
City SACRAMENTO
State CA
ZIP 95823
Phone 916 428-7990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type Physician Office
Lab Director VICKI P. DUONG

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