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05D2155228 CLIA NUMBER - PROVIDENCE MEDICAL FOUNDATION

Laboratory Demographics

CLIA Number: 05D2155228

Facility Name: PROVIDENCE MEDICAL FOUNDATION

Facility Address:
3200 WALFORD AVE
EUREKA, CA
ZIP 95503
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Facility Phone Number: 707 445-3443

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1386937225

Taxonomy: 207X00000X - Orthopaedic Surgery
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

CLIA Record

Field Name Field Value
CLIA Number 05D2155228
LAB Type Physician Office
Facility Name PROVIDENCE MEDICAL FOUNDATION
Street 3200 WALFORD AVE
City EUREKA
State CA
ZIP 95503
Phone 707 445-3443
CertificateType 3
CertificateEffectiveDate 9/25/2022
CertificateExpirationDate 9/24/2024
FacilityType PPMP

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This page was last updated on: 4/23/2024