05D0612626 CLIA NUMBER - NORTHBROOK HEALTHCARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0612626
  • Facility Name: NORTHBROOK HEALTHCARE CENTER
  • Facility Address: 64 NORTHBROOK WAY
    WILLITS, CA
    ZIP 95490
  • Facility Phone: 707 459-5592
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JOHN P. WILLIAMS, DO
  • NPI Number: 1639178809
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0612626
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name NORTHBROOK HEALTHCARE CENTER
Street 64 NORTHBROOK WAY
City WILLITS
State CA
ZIP 95490
Phone 707 459-5592
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 JOHN P. WILLIAMS, DO

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This page was last updated on: 6/4/2025