05D2320127 CLIA NUMBER - MUIR WOOD ADOLESCENT AND FAMILY SERVICES

Laboratory Demographics

  • CLIA Code: 05D2320127
  • Facility Name: MUIR WOOD ADOLESCENT AND FAMILY SERVICES
  • Facility Address: 320 WASHINGTON ST
    PETALUMA, CA
    ZIP 94952
  • Facility Phone: 415 497-7722
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DAVID E. SMITH
  • NPI Number: 1043997406
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D2320127
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MUIR WOOD ADOLESCENT AND FAMILY SERVICES
Street 320 WASHINGTON ST
City PETALUMA
State CA
ZIP 94952
Phone 415 497-7722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DAVID E. SMITH

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