05D0715109 CLIA NUMBER - CORDILLERAS MENTAL HEALTH REHAB CNTR

Laboratory Demographics

  • CLIA Code: 05D0715109
  • Facility Name: CORDILLERAS MENTAL HEALTH REHAB CNTR
  • Facility Address: 200 EDMONDS RD
    REDWOOD CITY, CA
    ZIP 94062
  • Facility Phone: 650 367-1890
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: EUGENE Y. LEE MD
  • NPI Number: 1033699772
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 05D0715109
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CORDILLERAS MENTAL HEALTH REHAB CNTR
Street 200 EDMONDS RD
City REDWOOD CITY
State CA
ZIP 94062
Phone 650 367-1890
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 EUGENE Y. LEE MD

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