05D0683704 CLIA NUMBER - LIBERTY AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 05D0683704
  • Facility Name: LIBERTY AMBULANCE SERVICE
  • Facility Address: 1325 W RIDGECREST BLVD
    RIDGECREST, CA
    ZIP 93555
  • Facility Phone: 619 375-6565
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: SCOTT D. ALLEN
  • NPI Number: 1962576660
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 05D0683704
LAB Type Other
Facility Name LIBERTY AMBULANCE SERVICE
Street 1325 W RIDGECREST BLVD
City RIDGECREST
State CA
ZIP 93555
Phone 619 375-6565
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 Other
Lab Director SCOTT D. ALLEN

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