05D2060646 CLIA NUMBER - WELLSPACE HEALTH TOM GAGEN COMMUNITY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 05D2060646
  • Facility Name: WELLSPACE HEALTH TOM GAGEN COMMUNITY HEALTH CENTER
  • Facility Address: 631 H ST
    SACRAMENTO, CA
    ZIP 95811
  • Facility Phone: 916 569-8650
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. JANINE W. BERA
  • NPI Number: 1265777692
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2060646
LAB Type Federally Qualified Health Center
Facility Name WELLSPACE HEALTH TOM GAGEN COMMUNITY HEALTH CENTER
Street 631 H ST
City SACRAMENTO
State CA
ZIP 95811
Phone 916 569-8650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Federally Qualified Health Center
Lab Director DR. JANINE W. BERA

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