05D0903219 CLIA NUMBER - BRENTWOOD NURSING & REHAB CENTER INC

Laboratory Demographics

  • CLIA Code: 05D0903219
  • Facility Name: BRENTWOOD NURSING & REHAB CENTER INC
  • Facility Address: 1795 WALNUT STREET
    RED BLUFF, CA
    ZIP 96080
  • Facility Phone: 916 527-2046
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROSS TYE MD
  • NPI Number: 1760840284
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0903219
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BRENTWOOD NURSING & REHAB CENTER INC
Street 1795 WALNUT STREET
City RED BLUFF
State CA
ZIP 96080
Phone 916 527-2046
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2024
Certificate Expiration Date 9/6/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ROSS TYE MD

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