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<br /> 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone (209)4.68-342D
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<br /> Lrt PERMIT TO OPERATE 4522 ACUTE CARE FACILIT ;
<br /> Permit ID# PT0000525 for Record ID# PR0450002
<br /> Valid From 1/1/2014 To 12/31/2014 .
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for: LODI MEMORIAL HOSPITAL
<br /> DBA: LODI MEMORIAL HOSPITAL -WEST
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility IDFA0000519
<br /> Regulated Facility: LODI MEMORIAL HOSPITAL WEST
<br /> DAccount ID AR0000518
<br /> 800 S LOWER SACRAMENTO RIssued11/22/2013
<br /> LODI CA 94240 `
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<br /> Billing Address: LODI MEMORIAL HOSPITAL WEST
<br /> 975 S FAIRMONT AVE HY
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<br /> LODI CA 95240
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