05D0977194 CLIA NUMBER - MISSION RANCH PRIMARY CARE, INC

Laboratory Demographics

  • CLIA Code: 05D0977194
  • Facility Name: MISSION RANCH PRIMARY CARE, INC
  • Facility Address: 114 MISSION RANCH BLVD, #10
    CHICO, CA
    ZIP 95926
  • Facility Phone: 530 894-0500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRYAN G. FURST
  • NPI Number: 1316497910
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0977194
LAB Type Physician Office
Facility Name MISSION RANCH PRIMARY CARE, INC
Street 114 MISSION RANCH BLVD, #10
City CHICO
State CA
ZIP 95926
Phone 530 894-0500
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 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Physician Office
Lab Director BRYAN G. FURST

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