FOLSOM STATE PRISON
NPI 1821621764
Pharmacy in Represa, CA
- Organization
- Pharmacy
- CLIA Number: 05D1083620
- CLIA Cert. Type: Prison
- CLIA Exp. Date: 07-08-2028
About FOLSOM STATE PRISON
This page provides the complete NPI Profile along with additional information for Folsom State Prison, a provider established in Represa, California operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1821621764 assigned on February 2020. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Folsom State Prison. The authorized official of this NPI record is Pierre Caesare Saucier James (Staff Services Manager I)
- NPI
- 1821621764 Verify this NPI
- Provider Legal Name
- CORRECTIONS AND REHABILITATION-HEADQUARTERS
- Other Organization Name
- FOLSOM STATE PRISON
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 300 PRISON ROAD REPRESA, CA 95671
- Location Phone
- (916) 985-2561
- Location Fax
- (916) 608-3112
- Mailing Address
- 300 PRISON ROAD REPRESA, CA 95671
- Mailing Phone
- (916) 985-2561
- Mailing Fax
- (916) 608-3112
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-19-2020
- Last Update Date
- 12-04-2024
- Code Navigator
Location Map
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
Pharmacy
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- Taxonomy Description
- A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
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
- 05D1083620
- Facility Type
- Prison
- Certificate Effective Date
- July 09, 2026
- Certificate Expiration Date
- July 08, 2028
- Laboratory Director
- DR. OLIVER LAU
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Folsom State Prison to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1821621764, enumerated as an "organization" on February 19, 2020.
The provider is located at 300 PRISON ROAD REPRESA, CA 95671 and the phone number is (916) 985-2561.
Pharmacy with taxonomy code 333600000X.
