05D2085569 CLIA NUMBER - NEWSTART MEDICAL GROUP INC DBA BLUE STONE H&W

Laboratory Demographics

  • CLIA Code: 05D2085569
  • Facility Name: NEWSTART MEDICAL GROUP INC DBA BLUE STONE H&W
  • Facility Address: 20601 WEST PAOLI LN
    WEIMAR, CA
    ZIP 95736
  • Facility Phone: 706 996-3311
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: ROGER D. GALLANT
  • NPI Number: 1508927344
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2085569
LAB Type Rural Health Clinic
Facility Name NEWSTART MEDICAL GROUP INC DBA BLUE STONE H&W
Street 20601 WEST PAOLI LN
City WEIMAR
State CA
ZIP 95736
Phone 706 996-3311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Rural Health Clinic
Lab Director ROGER D. GALLANT

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