05D2224604 CLIA NUMBER - AMERICAN RIVER PEDIATRIC AND ADOLESCENT MEDICINE

Laboratory Demographics

  • CLIA Code: 05D2224604
  • Facility Name: AMERICAN RIVER PEDIATRIC AND ADOLESCENT MEDICINE
  • Facility Address: 6357 COYLE AVE
    CARMICHAEL, CA
    ZIP 95608
  • Facility Phone: 916 924-8754
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JONATHAN E. THYGESON
  • NPI Number: 1639126287
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2224604
LAB Type Physician Office
Facility Name AMERICAN RIVER PEDIATRIC AND ADOLESCENT MEDICINE
Street 6357 COYLE AVE
City CARMICHAEL
State CA
ZIP 95608
Phone 916 924-8754
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Physician Office
Lab Director JONATHAN E. THYGESON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025