05D0965457 CLIA NUMBER - NEW BETHANY

Laboratory Demographics

  • CLIA Code: 05D0965457
  • Facility Name: NEW BETHANY
  • Facility Address: 1441 BERKELEY DRIVE
    LOS BANOS, CA
    ZIP 93635
  • Facility Phone: 209 827-8949
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KARTHIKEYA DEVIREDDY MD
  • NPI Number: 1083602304
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0965457
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name NEW BETHANY
Street 1441 BERKELEY DRIVE
City LOS BANOS
State CA
ZIP 93635
Phone 209 827-8949
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2023
Certificate Expiration Date 9/20/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KARTHIKEYA DEVIREDDY MD

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This page was last updated on: 6/4/2025