05D2132912 CLIA NUMBER - TET TOE MD INC

Laboratory Demographics

CLIA Number: 05D2132912

Facility Name: TET TOE MD INC

Facility Address:
1600 CREEKSIDE DR STE 2500
FOLSOM, CA
ZIP 95630
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Facility Phone Number: 916 542-1458

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1639618481

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2132912
LAB Type	Physician Office
Facility Name	TET TOE MD INC
Street	1600 CREEKSIDE DR STE 2500
City	FOLSOM
State	CA
ZIP	95630
Phone	916 542-1458
CertificateType	3
CertificateEffectiveDate	6/29/2023
CertificateExpirationDate	6/28/2025
FacilityType	PPMP

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