05D2327479 CLIA NUMBER - UC DAVIS HEALTH FOLSOM MEDICAL CARE CLINIC

Laboratory Demographics

  • CLIA Code: 05D2327479
  • Facility Name: UC DAVIS HEALTH FOLSOM MEDICAL CARE CLINIC
  • Facility Address: 14264 INNOVATION DRIVE
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 916 357-4830
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VICTOR BAQUERO
  • NPI Number: 1144432840
  • Taxonomy: 363LX0001X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 05D2327479
LAB Type Physician Office
Facility Name UC DAVIS HEALTH FOLSOM MEDICAL CARE CLINIC
Street 14264 INNOVATION DRIVE
City FOLSOM
State CA
ZIP 95630
Phone 916 357-4830
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Physician Office
Lab Director VICTOR BAQUERO

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