05D2055584 CLIA NUMBER - Live Well Medical Center

Laboratory Demographics

CLIA Number: 05D2055584

Facility Name: Live Well Medical Center

Facility Address:
515 Michigan Blvd.,
West Sacramento, CA
ZIP 95691
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Facility Phone Number: (916) 617-2515

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1285975060

Taxonomy: 208D00000X - General Practice

CLIA Record

Field Name Field Value
CLIA Number 05D2055584
LAB Type PHYSICIAN OFFICE
Facility Name Live Well Medical Center
Street 515 Michigan Blvd.,
City West Sacramento
State CA
ZIP 95691
Phone 9166172515

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This page was last updated on: 5/19/2019