05D0611927 CLIA NUMBER - ADVENTIST HEALTH CLEAR LAKE

Laboratory Demographics

  • CLIA Code: 05D0611927
  • Facility Name: ADVENTIST HEALTH CLEAR LAKE
  • Facility Address: 15630 18TH AVE
    CLEARLAKE, CA
    ZIP 95422
  • Facility Phone: 707 995-5778
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: ANTHONY E. VICTORIO
  • NPI Number: 1376510586
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D0611927
LAB Type Hospital
Facility Name ADVENTIST HEALTH CLEAR LAKE
Street 15630 18TH AVE
City CLEARLAKE
State CA
ZIP 95422
Phone 707 995-5778
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Hospital
Lab Director ANTHONY E. VICTORIO

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