05D0689173 CLIA NUMBER - WINDSOR ELMHAVEN CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0689173
  • Facility Name: WINDSOR ELMHAVEN CARE CENTER
  • Facility Address: 6940 PACIFIC AVENUE
    STOCKTON, CA
    ZIP 95207
  • Facility Phone: 209 477-4817
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT ASSIBEY
  • NPI Number: 1922027002
  • Taxonomy: 332BP3500X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 05D0689173
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WINDSOR ELMHAVEN CARE CENTER
Street 6940 PACIFIC AVENUE
City STOCKTON
State CA
ZIP 95207
Phone 209 477-4817
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 ROBERT ASSIBEY

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