05D1084436 CLIA NUMBER - MDSTAT URGENT CARE, INC.

Laboratory Demographics

CLIA Number: 05D1084436

Facility Name: MDSTAT URGENT CARE, INC.

Facility Address:
3860 EL DORADO HILLS BLVD., SUITE 601
EL DORADO HILLS, CA
ZIP 95762
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Facility Phone Number: 916 941-9222

Facility Type: Other - OUT PATIENT URGENT CARE

Certificate Type: Waiver

NPI Number: 1427421122

Taxonomy: 261QU0200X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	1/9/2023
CertificateExpirationDate	1/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024