05D2087007 CLIA NUMBER - PLACER PRIVATE PHYSICIANS

Laboratory Demographics

  • CLIA Code: 05D2087007
  • Facility Name: PLACER PRIVATE PHYSICIANS
  • Facility Address: 6960 DESTINY DR STE 100
    ROCKLIN, CA
    ZIP 95677
  • Facility Phone: 916 624-1777
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRON C. HEDMAN
  • NPI Number: 1164830360
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2087007
LAB Type Physician Office
Facility Name PLACER PRIVATE PHYSICIANS
Street 6960 DESTINY DR STE 100
City ROCKLIN
State CA
ZIP 95677
Phone 916 624-1777
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Physician Office
Lab Director BRON C. HEDMAN

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