05D2037435 CLIA NUMBER - ADVENTIST HEALTH CLEAR LAKE MEDICAL CTR - PULMONARY REHABILITATION

Laboratory Demographics

  • CLIA Code: 05D2037435
  • Facility Name: ADVENTIST HEALTH CLEAR LAKE MEDICAL CTR - PULMONARY REHABILITATION
  • Facility Address: 15322 LAKESHORE DRIVE
    CLEARLAKE, CA
    ZIP 95422
  • Facility Phone: 707 995-5778
  • Facility Type: Other - OUTPATIENT PULM FUNC TEST
  • Facility Type: Waiver
  • Lab Director: MARC R. SHAPIRO
  • NPI Number: 1063762896
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2037435
LAB Type Other - OUTPATIENT PULM FUNC TEST
Facility Name ADVENTIST HEALTH CLEAR LAKE MEDICAL CTR - PULMONARY REHABILITATION
Street 15322 LAKESHORE DRIVE
City CLEARLAKE
State CA
ZIP 95422
Phone 707 995-5778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Other - OUTPATIENT PULM FUNC TEST
Lab Director MARC R. SHAPIRO

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