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05D0904229 CLIA NUMBER - ROUND VALLEY INDIAN HEALTH CENTER PO BOX 247

Laboratory Demographics

CLIA Number: 05D0904229

Facility Name: ROUND VALLEY INDIAN HEALTH CENTER PO BOX 247

Facility Address:
HIGHWAY 162 AND BIGGAR LANE
COVELO, CA
ZIP 95428
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Facility Phone Number: 707 983-6181

Facility Type: Community Clinic

Certificate Type: Microscopy
NPI Number: 1669532750

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name Field Value
CLIA Number 05D0904229
LAB Type Community Clinic
Facility Name ROUND VALLEY INDIAN HEALTH CENTER PO BOX 247
Street HIGHWAY 162 AND BIGGAR LANE
City COVELO
State CA
ZIP 95428
Phone 707 983-6181
CertificateType 3
CertificateEffectiveDate 11/6/2023
CertificateExpirationDate 11/5/2025
FacilityType PPMP

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