05D0921678 CLIA NUMBER - PROVIDENCE ST JOSEPH HOSPITAL NORTH COAST PAIN & SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D0921678
  • Facility Name: PROVIDENCE ST JOSEPH HOSPITAL NORTH COAST PAIN & SURGERY CENTER
  • Facility Address: 2705 HARRIS ST
    EUREKA, CA
    ZIP 95503
  • Facility Phone: 773 354-1358
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RACHEL E. DONOHUE
  • NPI Number: 1649551086
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 05D0921678
LAB Type Ambulatory Surgery Center
Facility Name PROVIDENCE ST JOSEPH HOSPITAL NORTH COAST PAIN & SURGERY CENTER
Street 2705 HARRIS ST
City EUREKA
State CA
ZIP 95503
Phone 773 354-1358
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Ambulatory Surgery Center
Lab Director RACHEL E. DONOHUE

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