05D0725913 CLIA NUMBER - SAN LUIS CONVALESCENT HOSPITAL

Laboratory Demographics

  • CLIA Code: 05D0725913
  • Facility Name: SAN LUIS CONVALESCENT HOSPITAL
  • Facility Address: 709 N STREET
    NEWMAN, CA
    ZIP 95360
  • Facility Phone: 209 862-2862
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MICHAEL BRODIE
  • NPI Number: 1750375846
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0725913
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SAN LUIS CONVALESCENT HOSPITAL
Street 709 N STREET
City NEWMAN
State CA
ZIP 95360
Phone 209 862-2862
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 MICHAEL BRODIE

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