05D2215451 CLIA NUMBER - BROOKDALE PAULIN CREEK

Laboratory Demographics

  • CLIA Code: 05D2215451
  • Facility Name: BROOKDALE PAULIN CREEK
  • Facility Address: 2375 RANGE AVE
    SANTA ROSA, CA
    ZIP 95403
  • Facility Phone: 707 575-3722
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LUKE WATSON
  • NPI Number: 1740598036
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2215451
LAB Type Assisted Living Facility
Facility Name BROOKDALE PAULIN CREEK
Street 2375 RANGE AVE
City SANTA ROSA
State CA
ZIP 95403
Phone 707 575-3722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Assisted Living Facility
Lab Director LUKE WATSON

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