05D0615177 CLIA NUMBER - TAHOE FOREST MULTISPECIALITY CLINIC URGENT CARE TRUCKEE

Laboratory Demographics

CLIA Number: 05D0615177

Facility Name: TAHOE FOREST MULTISPECIALITY CLINIC URGENT CARE TRUCKEE

Facility Address:
10956 DONNER PASS RD, STE 110
TRUCKEE, CA
ZIP 96161
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Facility Phone Number: 530 581-8864

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1063068930

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D0615177
LAB Type	Other - URGENT CARE
Facility Name	TAHOE FOREST MULTISPECIALITY CLINIC URGENT CARE TRUCKEE
Street	10956 DONNER PASS RD, STE 110
City	TRUCKEE
State	CA
ZIP	96161
Phone	530 581-8864
CertificateType	4
CertificateEffectiveDate	11/21/2022
CertificateExpirationDate	11/20/2024
FacilityType	Waiver

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