05D2284358 CLIA NUMBER - DIGNITY HEALTH MEDICAL FOUNDATION

Laboratory Demographics

  • CLIA Code: 05D2284358
  • Facility Name: DIGNITY HEALTH MEDICAL FOUNDATION
  • Facility Address: 1735 CREEKSIDE DR
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 916 379-2861
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANN M. POWELSON
  • NPI Number: 1356389878
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 05D2284358
LAB Type Physician Office
Facility Name DIGNITY HEALTH MEDICAL FOUNDATION
Street 1735 CREEKSIDE DR
City FOLSOM
State CA
ZIP 95630
Phone 916 379-2861
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Physician Office
Lab Director ANN M. POWELSON

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