05D0725688 CLIA NUMBER - KIT CARSON NURSING AND REHABILITATION

Laboratory Demographics

  • CLIA Code: 05D0725688
  • Facility Name: KIT CARSON NURSING AND REHABILITATION
  • Facility Address: 811 COURT ST
    JACKSON, CA
    ZIP 95642
  • Facility Phone: 209 223-2231
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MARK FARYAN
  • NPI Number: 1467449603
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0725688
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name KIT CARSON NURSING AND REHABILITATION
Street 811 COURT ST
City JACKSON
State CA
ZIP 95642
Phone 209 223-2231
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 MARK FARYAN

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