05D0969807 CLIA NUMBER - FAMILY MEDICAL CENTER - ARNOLD

Laboratory Demographics

CLIA Number: 05D0969807

Facility Name: FAMILY MEDICAL CENTER - ARNOLD

Facility Address:
2182 HIGHWAY 4, STE A-100
ARNOLD, CA
ZIP 95223
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Facility Phone Number: 209 754-2565

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1790846301

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0969807
LAB Type	Rural Health Clinic
Facility Name	FAMILY MEDICAL CENTER - ARNOLD
Street	2182 HIGHWAY 4, STE A-100
City	ARNOLD
State	CA
ZIP	95223
Phone	209 754-2565
CertificateType	4
CertificateEffectiveDate	2/12/2024
CertificateExpirationDate	2/11/2026
FacilityType	Waiver

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