05D0683099 CLIA NUMBER - ALPINE COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 05D0683099
  • Facility Name: ALPINE COUNTY HEALTH DEPARTMENT
  • Facility Address: 75 B DIAMOND VALLEY ROAD
    MARKLEEVILLE, CA
    ZIP 96120
  • Facility Phone: 530 694-2146
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: RICHARD O. JOHNSON, MD
  • NPI Number: 1972039105
  • Taxonomy: 305S00000X - Point of Service

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CLIA Record

Field Name Field Value
CLIA Number 05D0683099
LAB Type Other
Facility Name ALPINE COUNTY HEALTH DEPARTMENT
Street 75 B DIAMOND VALLEY ROAD
City MARKLEEVILLE
State CA
ZIP 96120
Phone 530 694-2146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Other
Lab Director RICHARD O. JOHNSON, MD

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