05D0617355 CLIA NUMBER - WOLF CREEK CARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0617355
  • Facility Name: WOLF CREEK CARE CENTER
  • Facility Address: 107 CATHERINE LANE
    GRASS VALLEY, CA
    ZIP 95945
  • Facility Phone: 530 273-4447
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JON PRITCHETT
  • NPI Number: 1831198142
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0617355
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WOLF CREEK CARE CENTER
Street 107 CATHERINE LANE
City GRASS VALLEY
State CA
ZIP 95945
Phone 530 273-4447
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JON PRITCHETT

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This page was last updated on: 9/29/2025