05D2055670 CLIA NUMBER - WELLSPACE HEALTH ROSEVILLE COMMUNITY HEALTH CENTER

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Laboratory Demographics

CLIA Number: 05D2055670

Facility Name: WELLSPACE HEALTH ROSEVILLE COMMUNITY HEALTH CENTER

Facility Address:
5 MEDICAL PLAZA DR, STE 170
ROSEVILLE, CA
ZIP 95661
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Facility Phone Number: (916) 978-1738

Facility Type: FEDERALLY QUALIFIED HEALTH CENTER

Certificate Type: Waiver

NPI Number: 1811262348

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2055670
LAB Type	FEDERALLY QUALIFIED HEALTH CENTER
Facility Name	WELLSPACE HEALTH ROSEVILLE COMMUNITY HEALTH CENTER
Street	5 MEDICAL PLAZA DR, STE 170
City	ROSEVILLE
State	CA
ZIP	95661
Phone	(916) 978-1738

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This page was last updated on: 5/11/2023