05D2293465 CLIA NUMBER - RUPA THACKER MD CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2293465
  • Facility Name: RUPA THACKER MD CORPORATION
  • Facility Address: 6255 N FRESNO ST # 106
    FRESNO, CA
    ZIP 93710
  • Facility Phone: 559 336-4535
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUPA THACKER
  • NPI Number: 1275239311
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2293465
LAB Type Physician Office
Facility Name RUPA THACKER MD CORPORATION
Street 6255 N FRESNO ST # 106
City FRESNO
State CA
ZIP 93710
Phone 559 336-4535
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Physician Office
Lab Director RUPA THACKER

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