05D1061960 CLIA NUMBER - SUTTER COAST COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 05D1061960
  • Facility Name: SUTTER COAST COMMUNITY CLINIC
  • Facility Address: 780 E WASHINGTON BLVD
    CRESCENT CITY, CA
    ZIP 95531
  • Facility Phone: 707 464-5974
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: COURNEY P. RIDLEY MD
  • NPI Number: 1376909606
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 05D1061960
LAB Type Community Clinic
Facility Name SUTTER COAST COMMUNITY CLINIC
Street 780 E WASHINGTON BLVD
City CRESCENT CITY
State CA
ZIP 95531
Phone 707 464-5974
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Community Clinic
Lab Director COURNEY P. RIDLEY MD

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