05D1004724 CLIA NUMBER - BARTON COMMUNITY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 05D1004724
  • Facility Name: BARTON COMMUNITY HEALTH CENTER
  • Facility Address: 2201 SOUTH AVE
    SOUTH LAKE TAHOE, CA
    ZIP 96150
  • Facility Phone: 530 543-5623
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: MATTHEW WONNACOTT MD
  • NPI Number: 1053310326
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1004724
LAB Type Rural Health Clinic
Facility Name BARTON COMMUNITY HEALTH CENTER
Street 2201 SOUTH AVE
City SOUTH LAKE TAHOE
State CA
ZIP 96150
Phone 530 543-5623
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 10/15/2025
Certificate Expiration Date 10/14/2027
Facility Type Rural Health Clinic
Lab Director MATTHEW WONNACOTT MD

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