05D0604967 CLIA NUMBER - PETALUMA HEALTH AND REHABILITATION

Laboratory Demographics

  • CLIA Code: 05D0604967
  • Facility Name: PETALUMA HEALTH AND REHABILITATION
  • Facility Address: 300 DOUGLAS STREET
    PETALUMA, CA
    ZIP 94952
  • Facility Phone: 707 763-6887
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ERAN MATALON MD
  • NPI Number: 1538239215
  • Taxonomy: 332000000X - Military/U.S. Coast Guard Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D0604967
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PETALUMA HEALTH AND REHABILITATION
Street 300 DOUGLAS STREET
City PETALUMA
State CA
ZIP 94952
Phone 707 763-6887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ERAN MATALON MD

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