05D2039176 CLIA NUMBER - RAI CARE CENTERS OF NORTHERN CALIFORNIA I, LLC DBA RAI - MACK ROAD - SACRAMENTO

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Laboratory Demographics

CLIA Number: 05D2039176

Facility Name: RAI CARE CENTERS OF NORTHERN CALIFORNIA I, LLC DBA RAI - MACK ROAD - SACRAMENTO

Facility Address:
4660 MACK RD STE 168
SACRAMENTO, CA
ZIP 95823
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Facility Phone Number: 916 394-9312

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1184906745

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2039176
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RAI CARE CENTERS OF NORTHERN CALIFORNIA I, LLC DBA RAI - MACK ROAD - SACRAMENTO
Street	4660 MACK RD STE 168
City	SACRAMENTO
State	CA
ZIP	95823
Phone	916 394-9312
CertificateType	4
CertificateEffectiveDate	4/3/2024
CertificateExpirationDate	4/2/2026
FacilityType	Waiver

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