05D0614505 CLIA NUMBER - GOLD COUNTRY HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D0614505

Facility Name: GOLD COUNTRY HEALTH CENTER

Facility Address:
4301 GOLDEN CENTER DRIVE
PLACERVILLE, CA
ZIP 95667
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Facility Phone Number: 916 621-1100

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1376797340

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	05D0614505
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	GOLD COUNTRY HEALTH CENTER
Street	4301 GOLDEN CENTER DRIVE
City	PLACERVILLE
State	CA
ZIP	95667
Phone	916 621-1100
CertificateType	4
CertificateEffectiveDate	6/1/2023
CertificateExpirationDate	5/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024