05D2180603 CLIA NUMBER - NORTHBAY HEALTH - FAIRFIELD URGENT CARE

Laboratory Demographics

  • CLIA Code: 05D2180603
  • Facility Name: NORTHBAY HEALTH - FAIRFIELD URGENT CARE
  • Facility Address: 1320 TRAVIS BLVD, STE C
    FAIRFIELD, CA
    ZIP 94533
  • Facility Phone: 707 646-3504
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLAKE H. CLEVELAND
  • NPI Number: 1811027907
  • Taxonomy: 207XS0117X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 05D2180603
LAB Type Physician Office
Facility Name NORTHBAY HEALTH - FAIRFIELD URGENT CARE
Street 1320 TRAVIS BLVD, STE C
City FAIRFIELD
State CA
ZIP 94533
Phone 707 646-3504
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Physician Office
Lab Director BLAKE H. CLEVELAND

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