Healthcare Provider Details

I. General information

NPI: 1902728595
Provider Name (Legal Business Name): LUKE VALENCIA DCLS, MLS, HCLD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1664 N VIRGINIA ST
RENO NV
89557-0001
US

IV. Provider business mailing address

10 COLLEGE PKWY
FOLSOM CA
95630-6798
US

V. Phone/Fax

Practice location:
  • Phone: 530-620-5144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMTA-02028330
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number80874-RLD-0
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: