05D1084436 CLIA NUMBER - MDSTAT URGENT CARE, INC.

Laboratory Demographics

  • CLIA Code: 05D1084436
  • Facility Name: MDSTAT URGENT CARE, INC.
  • Facility Address: 3860 EL DORADO HILLS BLVD., SUITE 601
    EL DORADO HILLS, CA
    ZIP 95762
  • Facility Phone: 916 941-9222
  • Facility Type: Other - OUT PATIENT URGENT CARE
  • Facility Type: Waiver
  • Lab Director: WALI A. DANESH
  • NPI Number: 1427421122
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1084436
LAB Type Other - OUT PATIENT URGENT CARE
Facility Name MDSTAT URGENT CARE, INC.
Street 3860 EL DORADO HILLS BLVD., SUITE 601
City EL DORADO HILLS
State CA
ZIP 95762
Phone 916 941-9222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Other - OUT PATIENT URGENT CARE
Lab Director WALI A. DANESH

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