05D2203772 CLIA NUMBER - WELLSPACE HEALTH NORTH

Laboratory Demographics

  • CLIA Code: 05D2203772
  • Facility Name: WELLSPACE HEALTH NORTH
  • Facility Address: 4441 AUBURN BOULEVARD
    SACRAMENTO, CA
    ZIP 95814
  • Facility Phone: 916 473-5764
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: JANINE BERA
  • NPI Number: 1033295084
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2203772
LAB Type Federally Qualified Health Center
Facility Name WELLSPACE HEALTH NORTH
Street 4441 AUBURN BOULEVARD
City SACRAMENTO
State CA
ZIP 95814
Phone 916 473-5764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2024
Certificate Expiration Date 12/4/2026
Facility Type Federally Qualified Health Center
Lab Director JANINE BERA

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