05D2309597 CLIA NUMBER - SAUSAL CREEK OUTPATIENT

Laboratory Demographics

  • CLIA Code: 05D2309597
  • Facility Name: SAUSAL CREEK OUTPATIENT
  • Facility Address: 2620 26TH AVE
    OAKLAND, CA
    ZIP 94601
  • Facility Phone: 510 437-2363
  • Facility Type: Other - OUTPATIENT MH CLINIC
  • Facility Type: Waiver
  • Lab Director: MARK A. RITCHIE
  • NPI Number: 1629154786
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2309597
LAB Type Other - OUTPATIENT MH CLINIC
Facility Name SAUSAL CREEK OUTPATIENT
Street 2620 26TH AVE
City OAKLAND
State CA
ZIP 94601
Phone 510 437-2363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Other - OUTPATIENT MH CLINIC
Lab Director MARK A. RITCHIE

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