05D2113651 CLIA NUMBER - LINCOLN MEDICAL PRACTICE

Laboratory Demographics

CLIA Number: 05D2113651

Facility Name: LINCOLN MEDICAL PRACTICE

Facility Address:
901 STERLING PARKWAY SUITE 101
LINCOLN, CA
ZIP 95648
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Facility Phone Number: 916 434-8800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1588031157

Taxonomy: 261QP2300X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	5/26/2022
CertificateExpirationDate	5/25/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024