05D2241872 CLIA NUMBER - RICHARD W GRAHAM, DDS, INC

Laboratory Demographics

  • CLIA Code: 05D2241872
  • Facility Name: RICHARD W GRAHAM, DDS, INC
  • Facility Address: 5300 SNYDER LANE SUITE F
    ROHNERT PARK, CA
    ZIP 94928
  • Facility Phone: 707 584-9422
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RICHARD W. GRAHAM DDS
  • NPI Number: 1295728061
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D2241872
LAB Type Practitioner Other
Facility Name RICHARD W GRAHAM, DDS, INC
Street 5300 SNYDER LANE SUITE F
City ROHNERT PARK
State CA
ZIP 94928
Phone 707 584-9422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Practitioner Other
Lab Director RICHARD W. GRAHAM DDS

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