05D0613208 CLIA NUMBER - CHAPA DE INDIAN HEALTH PROGRAM, INC

Laboratory Demographics

  • CLIA Code: 05D0613208
  • Facility Name: CHAPA DE INDIAN HEALTH PROGRAM, INC
  • Facility Address: 11670 ATWOOD ROAD
    AUBURN, CA
    ZIP 95603
  • Facility Phone: 530 887-2810
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: WILLIAM JORNLIN
  • NPI Number: 1114057163
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0613208
LAB Type Community Clinic
Facility Name CHAPA DE INDIAN HEALTH PROGRAM, INC
Street 11670 ATWOOD ROAD
City AUBURN
State CA
ZIP 95603
Phone 530 887-2810
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Community Clinic
Lab Director WILLIAM JORNLIN

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