05D2306743 CLIA NUMBER - SAN LUIS OBISPO COUNTY JAIL HEALTHCARE

Laboratory Demographics

  • CLIA Code: 05D2306743
  • Facility Name: SAN LUIS OBISPO COUNTY JAIL HEALTHCARE
  • Facility Address: 1585 KANSAS AVENUE
    SAN LUIS OBISPO, CA
    ZIP 93405
  • Facility Phone: 805 781-4510
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: SETH A. STABINSKY
  • NPI Number: 1144251307
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 05D2306743
LAB Type Prison
Facility Name SAN LUIS OBISPO COUNTY JAIL HEALTHCARE
Street 1585 KANSAS AVENUE
City SAN LUIS OBISPO
State CA
ZIP 93405
Phone 805 781-4510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Prison
Lab Director SETH A. STABINSKY

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