COMMUNITY HEALTH CLINICAL LABORATORY LLC
NPI 1679109995
Clinical Medical Laboratory in Nipomo, CA

Active since March 18, 2020CLIA 05D2178991 · Accreditation
150 TEJAS PLACE, BLDG. B SUITE A, NIPOMO, CA 93444(805) 338-0460 Get Directions Write a Review

NPPES record last updated: March 19, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Community Health Clinical Laboratory Llc NPPES

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

COMMUNITY HEALTH CLINICAL LABORATORY LLC (NPI 1679109995) is a healthcare organization registered as a clinical medical laboratory in Nipomo, California and active in the NPI registry since March 2020. The organization holds an CLIA Accreditation certificate valid through June 1, 2027 and lists Alexandre Feoktistov, President, as its authorized official.

NPPES Registry Identity

NPI1679109995
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameCOMMUNITY HEALTH CLINICAL LABORATORY LLC
Location Address150 TEJAS PLACE, BLDG. B SUITE ANipomo, CA 93444
Mailing Address150 Tejas Place, Bldg. B Suite ANipomo, CA 93444 · (805) 338-0460
Organization SubpartNo
Authorized OfficialAlexandre FeoktistovPresident · (805) 338-0460
Enumeration DateMarch 18, 2020
Last NPPES UpdateMarch 19, 2020
NPPES CertifiedMarch 19, 2020
NPI 1679109995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(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.
150 TEJAS PLACE, Nipomo, CA 93444

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 05D2178991

Community Health Clinical Laboratory, LLC · Nipomo, CA
Active · expires Jun 1, 2027
CLIA Number05D2178991
Laboratory TypeIndependent
Certificate Effective DateJune 2, 2025
Certificate Expiration DateJune 1, 2027
Laboratory DirectorMr. Gary L. Burkhartsmeier
Laboratory Phone(805) 723-1010
Laboratory LocationCommunity Health Clinical Laboratory, LLC150 Tejas Place, Bldg B, Ste A, Nipomo, CA 93444
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.

Areas of Expertise CMS Part B claims 69

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
6,337 services4,514 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
5,383 services4,079 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
4,844 services3,806 patients
Blood test, thyroid stimulating hormone (tsh) 84443
A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
3,622 services2,998 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
3,251 services2,196 patients
Vitamin d-3 level 82306
A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.
1,979 services1,546 patients

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 Community Health Clinical Laboratory LLC's NPI number?

The NPI number for Community Health Clinical Laboratory LLC is 1679109995. It was assigned to this organization in the NPPES registry on March 18, 2020.

Where is Community Health Clinical Laboratory LLC located?

Community Health Clinical Laboratory LLC is located at 150 Tejas Place Bldg. B Suite A, Nipomo, CA 93444. The listed phone number is (805) 338-0460.

What is Community Health Clinical Laboratory LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Community Health Clinical Laboratory LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 05D2178991) is associated with this NPI, valid through June 1, 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 Community Health Clinical Laboratory LLC was last updated on March 19, 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.