05D2294554 CLIA NUMBER - PEACH TREE MEDICAL VAN

Laboratory Demographics

  • CLIA Code: 05D2294554
  • Facility Name: PEACH TREE MEDICAL VAN
  • Facility Address: 1275 THARO ROAD
    YUBA CITY, CA
    ZIP 95993
  • Facility Phone: 530 749-3242
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: GINA ROSSETTI
  • NPI Number: 1669152120
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2294554
LAB Type Mobile Laboratory
Facility Name PEACH TREE MEDICAL VAN
Street 1275 THARO ROAD
City YUBA CITY
State CA
ZIP 95993
Phone 530 749-3242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
Certificate Expiration Date 11/27/2025
Facility Type Mobile Laboratory
Lab Director GINA ROSSETTI

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