05D2113651 CLIA NUMBER - LINCOLN MEDICAL PRACTICE

Laboratory Demographics

  • CLIA Code: 05D2113651
  • Facility Name: LINCOLN MEDICAL PRACTICE
  • Facility Address: 901 STERLING PARKWAY SUITE 101
    LINCOLN, CA
    ZIP 95648
  • Facility Phone: 916 434-8800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SARALA GHANAPURAM
  • NPI Number: 1588031157
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2113651
LAB Type Physician Office
Facility Name LINCOLN MEDICAL PRACTICE
Street 901 STERLING PARKWAY SUITE 101
City LINCOLN
State CA
ZIP 95648
Phone 916 434-8800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type Physician Office
Lab Director SARALA GHANAPURAM

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