DIGNITY HEALTH LASSEN MEDICAL CLINIC-RED BLUFF
NPI 1407399678
Clinic/Center - Rural Health in Red Bluff, CA

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

Active since November 21, 2016CLIA 05D0618474 · Waiver

2450 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080(530) 527-0414(530) 528-4423 Get Directions Write a Review

NPPES record last updated: November 21, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dignity Health Lassen Medical Clinic-red Bluff NPPES

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

DIGNITY HEALTH LASSEN MEDICAL CLINIC-RED BLUFF (NPI 1407399678) is a healthcare organization registered as a rural health in Red Bluff, California and active in the NPI registry since November 2016. The organization holds a CLIA Waiver certificate valid through January 8, 2027 and lists Kim Miranda, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1407399678

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameDIGNITY HEALTH

Location Address2450 SISTER MARY COLUMBA DRRed Bluff, CA 96080-4356

Mailing Address2450 Sister Mary Columba DrRed Bluff, CA 96080-4356 · (530) 527-0414 · Fax (530) 528-4423

Phone(530) 527-0414

Fax(530) 528-4423

Organization SubpartYes

Authorized OfficialKim MirandaChief Financial Officer · (530) 225-6121

Enumeration DateNovember 21, 2016

✔ NPI 1407399678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

2450 SISTER MARY COLUMBA DR, Red Bluff, CA 96080

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Other Names 1

Doing Business AsDignity Health Lassen Medical Clinic-red Bluff

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 05D0618474

Dignity Health Lassen Medical Clinic Red Bluff · Red Bluff, CA

Active · expires Jan 8, 2027

CLIA Number05D0618474

Laboratory TypeHospital 1206 (d) Dept.

Certificate Effective DateJanuary 9, 2025

Certificate Expiration DateJanuary 8, 2027

Laboratory DirectorTikoes Blankenberg

Laboratory Phone(530) 527-0414

Laboratory LocationDignity Health Lassen Medical Clinic Red Bluff2450 Sister Mary Columba Dr, Red Bluff, CA 96080

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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.

SHELLY J RODGERS ANP

Registered Nurse