05D2329354 CLIA NUMBER - WELLSPACE HEALTH PLACER COMMUNITY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 05D2329354
  • Facility Name: WELLSPACE HEALTH PLACER COMMUNITY HEALTH CENTER
  • Facility Address: 100 STONEHOUSE CT SUITE 100
    ROSEVILLE, CA
    ZIP 95678
  • Facility Phone: 916 469-4705
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: JANINE BERA
  • NPI Number: 1245027655
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2329354
LAB Type Federally Qualified Health Center
Facility Name WELLSPACE HEALTH PLACER COMMUNITY HEALTH CENTER
Street 100 STONEHOUSE CT SUITE 100
City ROSEVILLE
State CA
ZIP 95678
Phone 916 469-4705
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Federally Qualified Health Center
Lab Director JANINE BERA

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