05D2101975 CLIA NUMBER - ST JOSEPH'S TOWER ICF/DD-N

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CLIA Record

Field Name Field Value
CLIA Number 05D2101975
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name ST JOSEPH'S TOWER ICF/DD-N
Street 1844 C ST
City RIO LINDA
State CA
ZIP 95673
Phone 916 238-4454
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director ANANT K. LODHIA

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