05D0985399 CLIA NUMBER - DIGNITY HEALTH MEDICAL FOUNDATION

Laboratory Demographics

  • CLIA Code: 05D0985399
  • Facility Name: DIGNITY HEALTH MEDICAL FOUNDATION
  • Facility Address: 401 E HIGHLAND AVE STE 450A
    SAN BERNARDINO, CA
    ZIP 92404
  • Facility Phone: 916 379-2861
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SWAPNA KUDTARKAR
  • NPI Number: 1689769911
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 05D0985399
LAB Type Physician Office
Facility Name DIGNITY HEALTH MEDICAL FOUNDATION
Street 401 E HIGHLAND AVE STE 450A
City SAN BERNARDINO
State CA
ZIP 92404
Phone 916 379-2861
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Physician Office
Lab Director SWAPNA KUDTARKAR

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