05D0972728 CLIA NUMBER - KAISER FOUNDATION HOME HEALTH SANTA ROSA

Laboratory Demographics

  • CLIA Code: 05D0972728
  • Facility Name: KAISER FOUNDATION HOME HEALTH SANTA ROSA
  • Facility Address: 3550 ROUND BARN BLVD
    SANTA ROSA, CA
    ZIP 95403
  • Facility Phone: 707 566-5488
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: COLIN THOMAS IBERTI
  • NPI Number: 1104996933
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D0972728
LAB Type Home Health Agency
Facility Name KAISER FOUNDATION HOME HEALTH SANTA ROSA
Street 3550 ROUND BARN BLVD
City SANTA ROSA
State CA
ZIP 95403
Phone 707 566-5488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Home Health Agency
Lab Director COLIN THOMAS IBERTI

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