MERCY LAKE SHASTINA COMMUNITY CLINIC
NPI 1255609699
Clinic/Center - Rural Health in Weed, CA

Active since December 13, 2011CLIA 05D2039442 · Waiver
16337 EVERHART DR, WEED, CA 96094(530) 938-2297(530) 938-0494 Get Directions Write a Review

NPPES record last updated: October 31, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mercy Lake Shastina Community Clinic NPPES

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

MERCY LAKE SHASTINA COMMUNITY CLINIC (NPI 1255609699) is a healthcare organization registered as a rural health in Weed, California and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through June 29, 2027 and lists Kim Miranda, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1255609699
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameDIGNITY HEALTH
Location Address16337 EVERHART DRWeed, CA 96094-9400
Mailing Address3400 Data Dr, 1st FloorRancho Cordova, CA 95670-7956 · (530) 225-6300 · Fax (530) 225-7278
Fax(530) 938-0494
Organization SubpartYes
Authorized OfficialKim MirandaChief Financial Officer · (530) 225-6121
Enumeration DateDecember 13, 2011
Last NPPES UpdateOctober 31, 2016
NPI 1255609699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
16337 EVERHART DR, Weed, CA 96094

Other Names 1

Doing Business AsMercy Lake Shastina Community Clinic

Other Identifiers 2

Other473431860Sp Tin
Medicare OSCAR/certification058662CA

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 Waiver 05D2039442

Mercy Lake Shastina Community Clinic · Weed, CA
Active · expires Jun 29, 2027
CLIA Number05D2039442
Laboratory TypeCommunity Clinic
Certificate Effective DateJune 30, 2025
Certificate Expiration DateJune 29, 2027
Laboratory DirectorMatthew J. Kilpatrick
Laboratory Phone(530) 926-9334
Laboratory LocationMercy Lake Shastina Community Clinic16337 Everhart Drive, Weed, CA 96094
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

Family Medicine
16337 EVERHART DR
WEED, CA 96094
Nurse Practitioner (Family)
16337 EVERHART DR
WEED, CA 96094
Nurse Practitioner (Family)
16337 EVERHART DR
WEED, CA 96094
Physician Assistant
16337 EVERHART DR
WEED, CA 96094
Family Medicine
16337 EVERHART DR
WEED, CA 96094

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 Dignity Health's NPI number?

The NPI number for Dignity Health is 1255609699. It was assigned to this organization in the NPPES registry on December 13, 2011. The provider is doing business as Mercy Lake Shastina Community Clinic.

Where is Dignity Health located?

Dignity Health is located at 16337 Everhart Dr, Weed, CA 96094. The listed phone number is (530) 938-2297.

What is Dignity Health's specialty?

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

Does Dignity Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2039442) is associated with this NPI, valid through June 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dignity Health was last updated on October 31, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.