05D0617412 CLIA NUMBER - ADVENTIST HEALTH PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 05D0617412
  • Facility Name: ADVENTIST HEALTH PHYSICIAN NETWORK
  • Facility Address: 1548 HIGHWAY 99
    GRIDLEY, CA
    ZIP 95948
  • Facility Phone: 530 751-4264
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GREGORY W. BURT
  • NPI Number: 1912553090
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0617412
LAB Type Physician Office
Facility Name ADVENTIST HEALTH PHYSICIAN NETWORK
Street 1548 HIGHWAY 99
City GRIDLEY
State CA
ZIP 95948
Phone 530 751-4264
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Physician Office
Lab Director DR. GREGORY W. BURT

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