05D2214602 CLIA NUMBER - VACAVALLEY HOME TRAINING

Laboratory Demographics

  • CLIA Code: 05D2214602
  • Facility Name: VACAVALLEY HOME TRAINING
  • Facility Address: 785 ORANGE DR
    VACAVILLE, CA
    ZIP 95687
  • Facility Phone: 707 359-1960
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: OLEG RUBIN
  • NPI Number: 1861603664
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D2214602
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name VACAVALLEY HOME TRAINING
Street 785 ORANGE DR
City VACAVILLE
State CA
ZIP 95687
Phone 707 359-1960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director OLEG RUBIN

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