CARSON-TAHOE PATHOLOGY DRS JACK & DOBERNECK LTD
NPI 1104971183
Clinical Medical Laboratory in Carson City, NV

NPI Status: Active since January 23, 2007

Contact Information

1600 MEDICAL PKWY
CARSON CITY, NV
ZIP 89703
Phone: (805) 250-5764
Fax: (775) 888-4448

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  • Organization
  • Clinical Medical Laboratory
  • CLIA Number: 29D0680086
  • CLIA Cert. Type: Independent
  • CLIA Exp. Date: 04-08-2027

About CARSON-TAHOE PATHOLOGY DRS JACK & DOBERNECK LTD

This page provides the complete NPI Profile along with additional information for Carson-tahoe Pathology Drs Jack & Doberneck Ltd, a provider established in Carson City, Nevada operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1104971183 assigned on January 2007. The practitioner's primary taxonomy code is 291U00000X with license number 5089 (NV). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's former legal business name is Dba Carson-tahoe Pathology, Ltd. The authorized official of this NPI record is Dr. Elizabeth Jack M.d. (Partner)

NPI
1104971183
Provider Legal Name
CARSON-TAHOE PATHOLOGY DRS JACK & DOBERNECK LTD
Other Organization Name
DBA CARSON-TAHOE PATHOLOGY, LTD
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
1600 MEDICAL PKWY CARSON CITY, NV 89703
Location Phone
(805) 250-5764
Location Fax
(775) 888-4448
Mailing Address
1633 ERRINGER RD STE 101 SIMI VALLEY, CA 93065
Mailing Phone
(805) 250-5764
Mailing Fax
(775) 888-4448
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-23-2007
Last Update Date
01-19-2023
Code Navigator

Establishments like Carson-tahoe Pathology Drs Jack & Doberneck Ltd are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.

Clinical labs in the U.S. that perform human testing are regulated by the Centers for Medicare & Medicaid Services (CMS) through the Clinical Laboratory Improvement Amendments (CLIA) program. The purpose of the CLIA program is to guarantee the quality of laboratory testing. This provider has a CLIA number assigned, and undergoes regular inspections to ensure compliance and quality.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinical Medical Laboratory

Taxonomy Code
291U00000X
Type
Laboratories
License No.
5089
License State
NV
Taxonomy Description
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ELIZABETH JACK M.D.

Authorized Official Title
PARTNER
Authorized Official Phone
(775) 445-8502

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
29D0680086
Facility Type
Independent
Certificate Effective Date
April 09, 2025
Certificate Expiration Date
April 08, 2027
Laboratory Director
MARK R WOLZ
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Carson-tahoe Pathology Drs Jack & Doberneck Ltd after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104971183, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
7
Unchanged
Pos 7
1
Doubled → 2
Pos 8
1
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 1 → 2 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 1 + 8 + 7 + 2 + 1 + 1 + 6 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1104971183.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

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Emergency Medicine
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Emergency Medicine
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Internal Medicine
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Anesthesiology
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Internal Medicine
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Hospitalist
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CARSON CITY, NV 89703
Licensed Practical Nurse
1600 MEDICAL PKWY
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Emergency Medicine
1600 MEDICAL PKWY
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Emergency Medicine
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Emergency Medicine
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Emergency Medicine
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Emergency Medicine
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Emergency Medicine
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Pathology (Clinical Pathology/Laboratory Medicine)
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Pathology (Clinical Pathology/Laboratory Medicine)
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Clinical Nurse Specialist (Adult Health)
1600 MEDICAL PKWY
CARSON CITY, NV 89703
Physical Medicine & Rehabilitation
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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104971183, enumerated as an "organization" on January 23, 2007.

The provider is located at 1600 MEDICAL PKWY CARSON CITY, NV 89703 and the phone number is (805) 250-5764.

Clinical Medical Laboratory with taxonomy code 291U00000X.