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UPPER LAKE CLINIC RHC
NPI 1053495879
Clinic/Center - Rural Health in Lakeport, CA

Active since October 25, 2006CLIA 05D0612179 · Accreditation
5176 HILL RD E, LAKEPORT, CA 95453(707) 262-5001(707) 262-5006 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Upper Lake Clinic Rhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UPPER LAKE CLINIC RHC (NPI 1053495879) is a healthcare organization registered as a rural health in Lakeport, California and active in the NPI registry since October 2006. The organization holds an CLIA Accreditation certificate valid through November 30, 2026 and lists Kelly Mather, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053495879
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSUTTER LAKESIDE HOSPITAL
Location Address5176 HILL RD ELakeport, CA 95453-6300
Mailing Address5176 Hill Rd ELakeport, CA 95453-6300 · (707) 262-5001 · Fax (707) 262-5006
Phone(707) 262-5001
Fax(707) 262-5006
Organization SubpartNo
Authorized OfficialKelly MatherCeo · (707) 262-5001
Enumeration DateOctober 25, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1053495879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
5176 HILL RD E, Lakeport, CA 95453
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Other Names 1

Other NameUpper Lake Clinic Rhc

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 05D0612179

Sutter Lakeside Hospital · Lakeport, CA
Active · expires Nov 30, 2026
CLIA Number05D0612179
Laboratory TypeHospital
Certificate Effective DateDecember 1, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorJudy Doyle
Laboratory Phone(707) 262-5011
Laboratory LocationSutter Lakeside Hospital5176 Hill Rd E, Lakeport, CA 95453
CLIA data matches this NPI record on: Address Name
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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MYRON P. SCHNEIDER MD
Radiology (Diagnostic Radiology)
5176 HILL RD E, DEPT OF IMAGING
LAKEPORT, CA 95453
Lake County (707) 262-5035
KIMBERLEY CURTIS ACUPUNCTURIST
Acupuncturist
5176 HILL RD E
LAKEPORT, CA 95453
Lake County (415) 264-0685
GERARD NGUYEN PHARMD
Pharmacist
5176 HILL RD E
LAKEPORT, CA 95453
Lake County (415) 497-8893
SUTTER LAKESIDE HOSPITAL
General Acute Care Hospital (Rural)
5176 HILL RD E
LAKEPORT, CA 95453
Lake County (707) 262-5181
HELEN V & FRED JOHNSON
Anesthesiology
5176 HILL RD E
LAKEPORT, CA 95453
Lake County (707) 262-5000
SUTTER LAKESIDE HOSPITAL
Clinic/Center (Rural Health)
5176 HILL RD E
LAKEPORT, CA 95453
Lake County (707) 262-5000
KATHLEEN E DUCHENE RD
Dietitian, Registered
5176 HILL RD E
LAKEPORT, CA 95453
Lake County (707) 262-5007
HAILEY BROOKE SOMMERFELD
Advanced Practice Midwife
5176 HILL RD E
LAKEPORT, CA 95453
Lake County (707) 262-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sutter Lakeside Hospital's NPI number?

The NPI number for Sutter Lakeside Hospital is 1053495879. It was assigned to this organization in the NPPES registry on October 25, 2006. The provider is also known as Upper Lake Clinic Rhc.

Where is Sutter Lakeside Hospital located?

Sutter Lakeside Hospital is located at 5176 Hill Rd E, Lakeport, CA 95453. The listed phone number is (707) 262-5001.

What is Sutter Lakeside Hospital's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Sutter Lakeside Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 05D0612179) is associated with this NPI, valid through November 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sutter Lakeside Hospital was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.