05D0724220 CLIA NUMBER - CALIFORNIA CORRECTIONAL INSTITUTION

Laboratory Demographics

CLIA Number: 05D0724220

Facility Name: CALIFORNIA CORRECTIONAL INSTITUTION

Facility Address:
24900 HIGHWAY 202
TEHACHAPI, CA
ZIP 93561
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Facility Phone Number: 661 633-4790

Facility Type: Prison

Certificate Type: Waiver

NPI Number: 1699027730

Taxonomy: 261QP2400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0724220
LAB Type	Prison
Facility Name	CALIFORNIA CORRECTIONAL INSTITUTION
Street	24900 HIGHWAY 202
City	TEHACHAPI
State	CA
ZIP	93561
Phone	661 633-4790
CertificateType	4
CertificateEffectiveDate	7/14/2022
CertificateExpirationDate	7/13/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024