05D0618371 CLIA NUMBER - KARUK COMMUNITY HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 05D0618371
  • Facility Name: KARUK COMMUNITY HEALTH CLINIC
  • Facility Address: 64236 SECOND AVENUE
    HAPPY CAMP, CA
    ZIP 96039
  • Facility Phone: 530 493-5257
  • Facility Type: Other - INDIAN HLTH CLNC KARUK TR
  • Facility Type: Microscopy
  • Lab Director: TONY E. VASQUEZ MD
  • NPI Number: 1952483406
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 05D0618371
LAB Type Other - INDIAN HLTH CLNC KARUK TR
Facility Name KARUK COMMUNITY HEALTH CLINIC
Street 64236 SECOND AVENUE
City HAPPY CAMP
State CA
ZIP 96039
Phone 530 493-5257
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Other - INDIAN HLTH CLNC KARUK TR
Lab Director TONY E. VASQUEZ MD

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