05D2207095 CLIA NUMBER - SAC CITY MD

Laboratory Demographics

  • CLIA Code: 05D2207095
  • Facility Name: SAC CITY MD
  • Facility Address: 8120 TIMBERLAKE WAY SUITE 108
    SACRAMENTO, CA
    ZIP 95823
  • Facility Phone: 916 252-5000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MALATHI SHANMUGAM
  • NPI Number: 1679180939
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2207095
LAB Type Physician Office
Facility Name SAC CITY MD
Street 8120 TIMBERLAKE WAY SUITE 108
City SACRAMENTO
State CA
ZIP 95823
Phone 916 252-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2024
Certificate Expiration Date 12/22/2026
Facility Type Physician Office
Lab Director MALATHI SHANMUGAM

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