05D0618474 CLIA NUMBER - DIGNITY HEALTH LASSEN MEDICAL CLINIC RED BLUFF

Laboratory Demographics

  • CLIA Code: 05D0618474
  • Facility Name: DIGNITY HEALTH LASSEN MEDICAL CLINIC RED BLUFF
  • Facility Address: 2450 SISTER MARY COLUMBA DR
    RED BLUFF, CA
    ZIP 96080
  • Facility Phone: 530 527-0414
  • Facility Type: Other - HOSPITAL 1206 (D) DEPT.
  • Facility Type: Waiver
  • Lab Director: TIKOES BLANKENBERG
  • NPI Number: 1407399678
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0618474
LAB Type Other - HOSPITAL 1206 (D) DEPT.
Facility Name DIGNITY HEALTH LASSEN MEDICAL CLINIC RED BLUFF
Street 2450 SISTER MARY COLUMBA DR
City RED BLUFF
State CA
ZIP 96080
Phone 530 527-0414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Other - HOSPITAL 1206 (D) DEPT.
Lab Director TIKOES BLANKENBERG

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