05D2154513 CLIA NUMBER - WELLSPACE HEALTH ARDEN ARCADE

Laboratory Demographics

CLIA Number: 05D2154513

Facility Name: WELLSPACE HEALTH ARDEN ARCADE

Facility Address:
2433 MARCONI AVENUE
SACRAMENTO, CA
ZIP 95821
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Facility Phone Number: 916 822-8970

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1548789050

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2154513
LAB Type	Federally Qualified Health Center
Facility Name	WELLSPACE HEALTH ARDEN ARCADE
Street	2433 MARCONI AVENUE
City	SACRAMENTO
State	CA
ZIP	95821
Phone	916 822-8970
CertificateType	3
CertificateEffectiveDate	9/14/2022
CertificateExpirationDate	9/13/2024
FacilityType	PPMP

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