05D0915060 CLIA NUMBER - SANTA YSABEL COMMUNITY HEALTH

Laboratory Demographics

  • CLIA Code: 05D0915060
  • Facility Name: SANTA YSABEL COMMUNITY HEALTH
  • Facility Address: 110 1/2 SCHOOL HOUSE CANYON RD
    SANTA YSABEL, CA
    ZIP 92070
  • Facility Phone: 760 765-4203
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DANIEL CALAC
  • NPI Number: 1073792032
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 05D0915060
LAB Type Federally Qualified Health Center
Facility Name SANTA YSABEL COMMUNITY HEALTH
Street 110 1/2 SCHOOL HOUSE CANYON RD
City SANTA YSABEL
State CA
ZIP 92070
Phone 760 765-4203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Federally Qualified Health Center
Lab Director DANIEL CALAC

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