05D1058960 CLIA NUMBER - UKIAH CBOC

Laboratory Demographics

CLIA Number: 05D1058960

Facility Name: UKIAH CBOC

Facility Address:
630 KINGS COURT
UKIAH, CA
ZIP 95482
Get Directions

Facility Phone Number: 707 468-7708

Facility Type: Community Clinic

Certificate Type: Accreditation

NPI Number: 1326100504

Taxonomy: 261QA0600X - Clinic/Center

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
CertificateType	1
CertificateEffectiveDate	9/19/2006
CertificateExpirationDate	5/22/2026
FacilityType	Accreditation

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This page was last updated on: 4/23/2024