05D0858103 CLIA NUMBER - SAN QUENTIN REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 05D0858103
  • Facility Name: SAN QUENTIN REHABILITATION CENTER
  • Facility Address: 1 MAIN ST
    SAN QUENTIN, CA
    ZIP 94964
  • Facility Phone: 415 454-1460
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: ALISON PACHYNSKI
  • NPI Number: 1710329925
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 05D0858103
LAB Type Prison
Facility Name SAN QUENTIN REHABILITATION CENTER
Street 1 MAIN ST
City SAN QUENTIN
State CA
ZIP 94964
Phone 415 454-1460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Prison
Lab Director ALISON PACHYNSKI

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