05D0862530 CLIA NUMBER - MARIPOSA COUNTY HEALTH DEPT

Laboratory Demographics

CLIA Number: 05D0862530

Facility Name: MARIPOSA COUNTY HEALTH DEPT

Facility Address:
5085 BULLION ST
MARIPOSA, CA
ZIP 95338
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Facility Phone Number: 209 966-3689

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1508907064

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	05D0862530
LAB Type	Other
Facility Name	MARIPOSA COUNTY HEALTH DEPT
Street	5085 BULLION ST
City	MARIPOSA
State	CA
ZIP	95338
Phone	209 966-3689
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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