05D0618299 CLIA NUMBER - PIT RIVER HEALTH SERVICE INC

Laboratory Demographics

  • CLIA Code: 05D0618299
  • Facility Name: PIT RIVER HEALTH SERVICE INC
  • Facility Address: 36977 PARK AVENUE
    BURNEY, CA
    ZIP 96013
  • Facility Phone: 530 335-3651
  • Facility Type: Other - TRIBAL CLINIC
  • Facility Type: Waiver
  • Lab Director: TAWANA NIX
  • NPI Number: 1891762985
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0618299
LAB Type Other - TRIBAL CLINIC
Facility Name PIT RIVER HEALTH SERVICE INC
Street 36977 PARK AVENUE
City BURNEY
State CA
ZIP 96013
Phone 530 335-3651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Other - TRIBAL CLINIC
Lab Director TAWANA NIX

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