05D0611774 CLIA NUMBER - SANTA ROSA POST ACUTE

Laboratory Demographics

  • CLIA Code: 05D0611774
  • Facility Name: SANTA ROSA POST ACUTE
  • Facility Address: 4650 HOEN AVE
    SANTA ROSA, CA
    ZIP 95405
  • Facility Phone: 707 546-0471
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DOMINIC J. PICETTI
  • NPI Number: 1720520273
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0611774
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SANTA ROSA POST ACUTE
Street 4650 HOEN AVE
City SANTA ROSA
State CA
ZIP 95405
Phone 707 546-0471
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DOMINIC J. PICETTI

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