05D2174080 CLIA NUMBER - CORE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 05D2174080
  • Facility Name: CORE MEDICAL CLINIC
  • Facility Address: 3990 INDUSTRIAL BOULEVARD
    WEST SACRAMENTO, CA
    ZIP 95691
  • Facility Phone: 916 796-0020
  • Facility Type: Other - OPIOD TREATMENT PROGRAM
  • Facility Type: Waiver
  • Lab Director: BELL R. CHRISTINE
  • NPI Number: 1750865804
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2174080
LAB Type Other - OPIOD TREATMENT PROGRAM
Facility Name CORE MEDICAL CLINIC
Street 3990 INDUSTRIAL BOULEVARD
City WEST SACRAMENTO
State CA
ZIP 95691
Phone 916 796-0020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2023
Certificate Expiration Date 10/22/2025
Facility Type Other - OPIOD TREATMENT PROGRAM
Lab Director BELL R. CHRISTINE

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