05D2103597 CLIA NUMBER - GATEWAY MEDICAL SERVICES INC

Laboratory Demographics

  • CLIA Code: 05D2103597
  • Facility Name: GATEWAY MEDICAL SERVICES INC
  • Facility Address: 9461 DESCHUTES RD STE 4
    PALO CEDRO, CA
    ZIP 96073
  • Facility Phone: 530 547-5305
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN T. MUNRO
  • NPI Number: 1770993370
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2103597
LAB Type Physician Office
Facility Name GATEWAY MEDICAL SERVICES INC
Street 9461 DESCHUTES RD STE 4
City PALO CEDRO
State CA
ZIP 96073
Phone 530 547-5305
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2025
Certificate Expiration Date 10/14/2027
Facility Type Physician Office
Lab Director JOHN T. MUNRO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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