05D0862779 CLIA NUMBER - ADVENTIST HEALTH LODI MEMORIAL

Laboratory Demographics

  • CLIA Code: 05D0862779
  • Facility Name: ADVENTIST HEALTH LODI MEMORIAL
  • Facility Address: 1235 W VINE ST STE 20
    LODI, CA
    ZIP 95240
  • Facility Phone: 209 339-7886
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: XAVIER SALINAS MD
  • NPI Number: 1073193603
  • Taxonomy: 207RC0000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0862779
LAB Type Community Clinic
Facility Name ADVENTIST HEALTH LODI MEMORIAL
Street 1235 W VINE ST STE 20
City LODI
State CA
ZIP 95240
Phone 209 339-7886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2025
Certificate Expiration Date 10/21/2027
Facility Type Community Clinic
Lab Director XAVIER SALINAS MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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