05D0612009 CLIA NUMBER - ADVENTIST HEALTH MENDOCINO COAST

Laboratory Demographics

  • CLIA Code: 05D0612009
  • Facility Name: ADVENTIST HEALTH MENDOCINO COAST
  • Facility Address: 700 RIVER DR
    FORT BRAGG, CA
    ZIP 95437
  • Facility Phone: 707 961-4659
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: NICHOLAS HARDING-JACKSON
  • NPI Number: 1043604705
  • Taxonomy: 261QM1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0612009
LAB Type Hospital
Facility Name ADVENTIST HEALTH MENDOCINO COAST
Street 700 RIVER DR
City FORT BRAGG
State CA
ZIP 95437
Phone 707 961-4659
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 NICHOLAS HARDING-JACKSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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