NPIMap

Organization Active NPI

County of Sacramento

Doing business as Public Health Laboratory

  • Clinical Medical Laboratory
  • Sacramento, CA
National Provider Identifier
1992876692
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
05D0644185 Issued in CA
Legal business name
COUNTY OF SACRAMENTO
Doing business as
Public Health Laboratory
Practice address
4600 Broadway
Suite 2300
Sacramento, CA 95820-1527
Phone
(916) 874-9231
Fax
(916) 874-9432
NPI assigned
Nov 13, 2006
Last updated
Sep 23, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF SACRAMENTOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Glennah Trochet, MD
Title
Sac County Public Health Officer
Phone
(916) 875-5881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 05D0644185 CA Primary

Addresses

Primary practice location

4600 Broadway
Suite 2300
Sacramento, CA 95820-1527

Mailing address

7001A East Pkwy
Suite 600
Sacramento, CA 95823-2501
Phone (916) 875-5881

Other identifiers 3

IdentifierTypeStateIssuer
LAB58561FMedicaidCA
05D0644185OtherCACLIA
1188OtherCAPH LABORATORY APPRV #

Other names 1

  • Public Health Laboratory Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040519001679 CA Part B Supplier - Independent Clinical Laboratory 0345231247 Practice locations: Sacramento, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0616630Sacramento County Clinics Program4600 Broadway, Sacramento, CA 95820Provider-performed microscopyAug 31, 2026
05D0644185Sacramento County Public Health Lab4600 Broadway, Ste 2300, Sacramento, CA 95820ComplianceJun 30, 2026
05D2289676Sacramento County Public Health Sexual Health4600 Broadway Suite 1400, Sacramento, CA 95820Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Elk Grove Fire Dept88 organizations share this tax ID, including this one
Part of
Elk Grove Fire Dept

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

7001A East Pkwy
Ste 600
Sacramento, CA 95823
Phone (916) 875-5881

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sacramento County Health CenterSacramento, CA, CCN 751181 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2003
Nov 1, 2003

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • County of Sacramento

    dba Sacramento County Health Center

    • Federally Qualified Health Center (FQHC)
    • Sacramento, CA
    • NPI 1366513061

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1992876692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001A EAST PKWY",
            "address_2": "SUITE 600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232501",
            "telephone_number": "916-875-5881",
            "fax_number": "916-875-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BROADWAY",
            "address_2": "SUITE 2300",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201527",
            "telephone_number": "916-874-9231",
            "fax_number": "916-874-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SACRAMENTO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SACRAMENTO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "TROCHET",
        "authorized_official_first_name": "GLENNAH",
        "authorized_official_title_or_position": "SAC COUNTY PUBLIC HEALTH OFFICER",
        "authorized_official_telephone_number": "916-875-5881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0644185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB58561F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0644185",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PH LABORATORY APPRV #",
            "identifier": "1188",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Public Health Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.