05D0710875 CLIA NUMBER - SPRING HILL MANOR CONVALESCENT HOSP

Laboratory Demographics

  • CLIA Code: 05D0710875
  • Facility Name: SPRING HILL MANOR CONVALESCENT HOSP
  • Facility Address: 355 JOERSCHKE DRIVE
    GRASS VALLEY, CA
    ZIP 95945
  • Facility Phone: 916 273-7247
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DOROTHY KISHIYAMA
  • NPI Number: 1457443947
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 05D0710875
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SPRING HILL MANOR CONVALESCENT HOSP
Street 355 JOERSCHKE DRIVE
City GRASS VALLEY
State CA
ZIP 95945
Phone 916 273-7247
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 DOROTHY KISHIYAMA

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