05D0716780 CLIA NUMBER - ALLIANCE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 05D0716780
  • Facility Name: ALLIANCE MEDICAL CENTER
  • Facility Address: 1381 UNIVERSITY AVE
    HEALDSBURG, CA
    ZIP 95448
  • Facility Phone: 707 433-5494
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: ANNA EKSTROM
  • NPI Number: 1710218409
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0716780
LAB Type Federally Qualified Health Center
Facility Name ALLIANCE MEDICAL CENTER
Street 1381 UNIVERSITY AVE
City HEALDSBURG
State CA
ZIP 95448
Phone 707 433-5494
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Federally Qualified Health Center
Lab Director ANNA EKSTROM

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