PELICAN BAY STATE PRISON
NPI 1437280153
Clinic/Center - Prison Health in Crescent City, CA
About Pelican Bay State Prison NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PELICAN BAY STATE PRISON (NPI 1437280153) is a healthcare organization registered as a prison health in Crescent City, California and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through June 22, 2028 and lists Maureen Mclean, Health Care Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 05D0890527
Pelican Bay State Prison Clinical Laboratory · Crescent City, CAOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Cdcr-Pbsp's NPI number?
The NPI number for Cdcr-Pbsp is 1437280153. It was assigned to this organization in the NPPES registry on March 7, 2007. The provider is also known as Pelican Bay State Prison.
Where is Cdcr-Pbsp located?
Cdcr-Pbsp is located at 5905 Lake Earl Dr, Crescent City, CA 95532. The listed phone number is (707) 465-1000.
What is Cdcr-Pbsp's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Prison Health, with taxonomy code 261QP2400X.
Does Cdcr-Pbsp hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0890527) is associated with this NPI, valid through June 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Cdcr-Pbsp was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Pelican Bay State Prison · NPI 1437280153
Prison Health organization in Crescent City, California. Organization record, active in the CMS NPPES registry since March 7, 2007.
## Identity
- **NPI:** 1437280153 (Entity type: Organization)
- **Enumerated:** March 7, 2007
- **Primary specialty:** Clinic/Center - Prison Health · taxonomy 261QP2400X
- **Legal business name:** Cdcr-Pbsp
- **Organization subpart:** No
- **Authorized official:** Maureen Mclean, HEALTH CARE MANAGER
## Practice location
- **Address:** 5905 LAKE EARL DR, Crescent City, CA 95532-0001
- **Phone:** (707) 465-1000
## Record status
- **NPPES last updated:** August 22, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1437280153) · Data from the CMS NPPES public registry.