05D0611996 CLIA NUMBER - MENDOCINO COAST ADVENTIST HEALTH MEDICAL OFFICES

Laboratory Demographics

  • CLIA Code: 05D0611996
  • Facility Name: MENDOCINO COAST ADVENTIST HEALTH MEDICAL OFFICES
  • Facility Address: 721 RIVER DR STE A
    FORT BRAGG, CA
    ZIP 95437
  • Facility Phone: 707 961-4659
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: ZOE BERNA
  • NPI Number: 1124220249
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0611996
LAB Type Rural Health Clinic
Facility Name MENDOCINO COAST ADVENTIST HEALTH MEDICAL OFFICES
Street 721 RIVER DR STE A
City FORT BRAGG
State CA
ZIP 95437
Phone 707 961-4659
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2023
Certificate Expiration Date 7/30/2025
Facility Type Rural Health Clinic
Lab Director ZOE BERNA

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This page was last updated on: 3/20/2025