05D0700683 CLIA NUMBER - STEPHEN KOLPACOFF MD

Laboratory Demographics

  • CLIA Code: 05D0700683
  • Facility Name: STEPHEN KOLPACOFF MD
  • Facility Address: 101 E OBERLIN ROAD
    YREKA, CA
    ZIP 96097
  • Facility Phone: 530 841-8500
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: STEPHEN E. KOLPACOFF
  • NPI Number: 1437153384
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0700683
LAB Type Rural Health Clinic
Facility Name STEPHEN KOLPACOFF MD
Street 101 E OBERLIN ROAD
City YREKA
State CA
ZIP 96097
Phone 530 841-8500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Rural Health Clinic
Lab Director STEPHEN E. KOLPACOFF

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