05D0988292 CLIA NUMBER - DIVIDE WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 05D0988292
  • Facility Name: DIVIDE WELLNESS CENTER
  • Facility Address: 6065 HWY 193
    GEORGETOWN, CA
    ZIP 95634
  • Facility Phone: 530 333-2548
  • Facility Type: Hospital
  • Facility Type: Microscopy
  • Lab Director: PETER M. BARBA
  • NPI Number: 1346226693
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0988292
LAB Type Hospital
Facility Name DIVIDE WELLNESS CENTER
Street 6065 HWY 193
City GEORGETOWN
State CA
ZIP 95634
Phone 530 333-2548
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 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Hospital
Lab Director PETER M. BARBA

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