05D2289948 CLIA NUMBER - HOPE COOPERATIVE

Laboratory Demographics

CLIA Number: 05D2289948

Facility Name: HOPE COOPERATIVE

Facility Address:
3737 MARCONI AVE
SACRAMENTO, CA
ZIP 95821
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Facility Phone Number: 916 441-0123

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1043943376

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	05D2289948
LAB Type	Practitioner Other
Facility Name	HOPE COOPERATIVE
Street	3737 MARCONI AVE
City	SACRAMENTO
State	CA
ZIP	95821
Phone	916 441-0123
CertificateType	4
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024