05D2041068 CLIA NUMBER - WOODLAND RESIDENTIAL SERVICES MARSHALL PROGRAM

Laboratory Demographics

  • CLIA Code: 05D2041068
  • Facility Name: WOODLAND RESIDENTIAL SERVICES MARSHALL PROGRAM
  • Facility Address: 1000 4TH ST
    WOODLAND, CA
    ZIP 95695
  • Facility Phone: 530 419-0059
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: ANANT LODHIA
  • NPI Number: 1730348764
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2041068
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name WOODLAND RESIDENTIAL SERVICES MARSHALL PROGRAM
Street 1000 4TH ST
City WOODLAND
State CA
ZIP 95695
Phone 530 419-0059
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director ANANT LODHIA

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