05D2118530 CLIA NUMBER - FOLSOM SIERRA ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 05D2118530
  • Facility Name: FOLSOM SIERRA ENDOSCOPY CENTER
  • Facility Address: 1671 CREEKSIDE DR STE 100
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 916 673-1990
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NAZIR RAHIM, MD
  • NPI Number: 1295897585
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2118530
LAB Type Ambulatory Surgery Center
Facility Name FOLSOM SIERRA ENDOSCOPY CENTER
Street 1671 CREEKSIDE DR STE 100
City FOLSOM
State CA
ZIP 95630
Phone 916 673-1990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Ambulatory Surgery Center
Lab Director NAZIR RAHIM, MD

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