05D2280907 CLIA NUMBER - VITALANT MATHER HLA LABORATORY

Laboratory Demographics

  • CLIA Code: 05D2280907
  • Facility Name: VITALANT MATHER HLA LABORATORY
  • Facility Address: 10585 ARMSTRONG AVE, RM 41
    MATHER, CA
    ZIP 95655
  • Facility Phone: 916 453-3684
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: BOBBIE S. RHODES-CLARK
  • NPI Number: 1578003380
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D2280907
LAB Type Independent
Facility Name VITALANT MATHER HLA LABORATORY
Street 10585 ARMSTRONG AVE, RM 41
City MATHER
State CA
ZIP 95655
Phone 916 453-3684
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Independent
Lab Director BOBBIE S. RHODES-CLARK

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