NPIMap

Organization Active NPI

Dignity Health

Doing business as HealthCare Clinical Laboratories

  • Clinical Medical Laboratory
  • Stockton, CA
National Provider Identifier
1780807248
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CA CLF2633 Issued in CA
Legal business name
DIGNITY HEALTH
Doing business as
HealthCare Clinical Laboratories
Practice address
2102 N California St
Stockton, CA 95204-6031
Phone
(209) 467-6396
Fax
(209) 467-6513
NPI assigned
Apr 11, 2007
Last updated
Sep 23, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
DIGNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Doreen Hartmann
Title
Chief Financial Officer
Phone
(209) 467-6442

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X CA CLF2633 CA
Clinical Medical Laboratory 291U00000X CA CLF2633 CA Primary

Addresses

Primary practice location

2102 N California St
Stockton, CA 95204-6031

Mailing address

1800 N California St
Stockton, CA 95204-6019
Phone (209) 467-6396

Other identifiers 6

IdentifierTypeStateIssuer
HSP40084GMedicaidCA
651191369952040002OtherWPS TRICARE
HSP40084LMedicaidCA
651191369OtherIRS - SP TAX ID
300181900OtherDOL - WORKERS COMP
ZZZ53996YOtherBSCA

Other names 1

  • HealthCare Clinical Laboratories Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0609125Healthcare Clinical Laboratory2102 N California St, Stockton, CA 95204AccreditationApr 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Ctr74 organizations share this tax ID, including this one
Part of
Mercy Medical Ctr

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379894400000",
    "number": "1780807248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-467-6396",
            "fax_number": "209-467-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046031",
            "telephone_number": "209-467-6396",
            "fax_number": "209-467-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIGNITY HEALTH",
        "enumeration_date": "2007-04-11",
        "last_updated": "2013-09-23",
        "status": "A",
        "authorized_official_last_name": "HARTMANN",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "209-467-6442"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "CA CLF2633",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CA CLF2633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40084G",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS TRICARE",
            "identifier": "651191369952040002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40084L",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS - SP TAX ID",
            "identifier": "651191369",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL - WORKERS COMP",
            "identifier": "300181900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSCA",
            "identifier": "ZZZ53996Y",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthCare Clinical Laboratories",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.