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05D1013574 CLIA NUMBER - TABLE MOUNTAIN RANCHERA MEDICAL CENTER

Laboratory Demographics

CLIA Number: 05D1013574

Facility Name: TABLE MOUNTAIN RANCHERA MEDICAL CENTER

Facility Address:
23638 SKY HARBOUR RD
FRIANT, CA
ZIP 93626
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Facility Phone Number: 559 822-3785

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1093983389

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 05D1013574
LAB Type Physician Office
Facility Name TABLE MOUNTAIN RANCHERA MEDICAL CENTER
Street 23638 SKY HARBOUR RD
City FRIANT
State CA
ZIP 93626
Phone 559 822-3785
CertificateType 4
CertificateEffectiveDate 6/11/2023
CertificateExpirationDate 6/10/2025
FacilityType Waiver

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