05D0865386 CLIA NUMBER - FIREBAUGH FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D0865386

Facility Name: FIREBAUGH FAMILY HEALTH CENTER

Facility Address:
992 O STREET
FIREBAUGH, CA
ZIP 93622
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Facility Phone Number: 559 659-3011

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1922768159

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0865386
LAB Type	Physician Office
Facility Name	FIREBAUGH FAMILY HEALTH CENTER
Street	992 O STREET
City	FIREBAUGH
State	CA
ZIP	93622
Phone	559 659-3011
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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