05D0566942 CLIA NUMBER - HUMANGOOD SOCAL DBA REDWOOD TERRACE HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D0566942

Facility Name: HUMANGOOD SOCAL DBA REDWOOD TERRACE HEALTH CENTER

Facility Address:
710 WEST 13TH AVENUE
ESCONDIDO, CA
ZIP 92025
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Facility Phone Number: 760 291-2701

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1366078115

Taxonomy: 261QR0401X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0566942
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	HUMANGOOD SOCAL DBA REDWOOD TERRACE HEALTH CENTER
Street	710 WEST 13TH AVENUE
City	ESCONDIDO
State	CA
ZIP	92025
Phone	760 291-2701
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024