05D0618500 CLIA NUMBER - SHINGLETOWN MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 05D0618500
  • Facility Name: SHINGLETOWN MEDICAL CENTER
  • Facility Address: 31292 ALPINE MEADOWS ROAD
    SHINGLETOWN, CA
    ZIP 96088
  • Facility Phone: 530 474-3390
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: STEVEN LICATA
  • NPI Number: 1750387072
  • Taxonomy: 261QF0400X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0618500
LAB Type Federally Qualified Health Center
Facility Name SHINGLETOWN MEDICAL CENTER
Street 31292 ALPINE MEADOWS ROAD
City SHINGLETOWN
State CA
ZIP 96088
Phone 530 474-3390
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Federally Qualified Health Center
Lab Director STEVEN LICATA

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