05D0614071 CLIA NUMBER - FOLSOM CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0614071
  • Facility Name: FOLSOM CONVALESCENT HOSPITAL
  • Facility Address: 510 MILL STREET
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 916 985-3641
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LINDA A. MICHAEL
  • NPI Number: 1679505572
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0614071
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FOLSOM CONVALESCENT HOSPITAL
Street 510 MILL STREET
City FOLSOM
State CA
ZIP 95630
Phone 916 985-3641
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 LINDA A. MICHAEL

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