05D2155354 CLIA NUMBER - WELLSPACE HEALTH ALTERNATIVE HOUSE

Laboratory Demographics

  • CLIA Code: 05D2155354
  • Facility Name: WELLSPACE HEALTH ALTERNATIVE HOUSE
  • Facility Address: 1550 JULIESSE AVENUE
    SACRAMENTO, CA
    ZIP 95815
  • Facility Phone: 916 313-8434
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JANINE BERA
  • NPI Number: 1114791332
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2155354
LAB Type Comp. Outpatient Rehab Facility
Facility Name WELLSPACE HEALTH ALTERNATIVE HOUSE
Street 1550 JULIESSE AVENUE
City SACRAMENTO
State CA
ZIP 95815
Phone 916 313-8434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director JANINE BERA

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