05D1058960 CLIA NUMBER - UKIAH CBOC

Laboratory Demographics

  • CLIA Code: 05D1058960
  • Facility Name: UKIAH CBOC
  • Facility Address: 630 KINGS COURT
    UKIAH, CA
    ZIP 95482
  • Facility Phone: 707 468-7708
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: TIFFANY CHAMBERS
  • NPI Number: 1326100504
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1058960
LAB Type Community Clinic
Facility Name UKIAH CBOC
Street 630 KINGS COURT
City UKIAH
State CA
ZIP 95482
Phone 707 468-7708
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/19/2006
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director TIFFANY CHAMBERS

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