05D2269433 CLIA NUMBER - ERIC BLASINGAME DDS, MS, INC TEAM PERIO

Laboratory Demographics

  • CLIA Code: 05D2269433
  • Facility Name: ERIC BLASINGAME DDS, MS, INC TEAM PERIO
  • Facility Address: 384 HARTNELL AVE
    REDDING, CA
    ZIP 96002
  • Facility Phone: 530 241-3302
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ERIC BLASINGAME
  • NPI Number: 1720227812
  • Taxonomy: 1223P0300X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D2269433
LAB Type Practitioner Other
Facility Name ERIC BLASINGAME DDS, MS, INC TEAM PERIO
Street 384 HARTNELL AVE
City REDDING
State CA
ZIP 96002
Phone 530 241-3302
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Practitioner Other
Lab Director ERIC BLASINGAME

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