05D0700276 CLIA NUMBER - MATTHEW C BLUNDELL, MD DBA CRESCENT CITY INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 05D0700276
  • Facility Name: MATTHEW C BLUNDELL, MD DBA CRESCENT CITY INTERNAL MEDICINE
  • Facility Address: 1771 NORTHCREST DRIVE
    CRESCENT CITY, CA
    ZIP 95531
  • Facility Phone: 707 465-8666
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW C. BLUNDELL MD
  • NPI Number: 1073511796
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0700276
LAB Type Physician Office
Facility Name MATTHEW C BLUNDELL, MD DBA CRESCENT CITY INTERNAL MEDICINE
Street 1771 NORTHCREST DRIVE
City CRESCENT CITY
State CA
ZIP 95531
Phone 707 465-8666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type Physician Office
Lab Director MATTHEW C. BLUNDELL MD

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