05D0612511 CLIA NUMBER - ADVENTIST HEALTH UKIAH VALLEY

Laboratory Demographics

  • CLIA Code: 05D0612511
  • Facility Name: ADVENTIST HEALTH UKIAH VALLEY
  • Facility Address: 260 HOSPITAL DR
    UKIAH, CA
    ZIP 95482
  • Facility Phone: 707 463-8000
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: JODI PARUNGOO MD
  • NPI Number: 1144561770
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0612511
LAB Type Rural Health Clinic
Facility Name ADVENTIST HEALTH UKIAH VALLEY
Street 260 HOSPITAL DR
City UKIAH
State CA
ZIP 95482
Phone 707 463-8000
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Rural Health Clinic
Lab Director JODI PARUNGOO MD

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