05D2027724 CLIA NUMBER - BI-VALLEY MEDICAL CLINIC, INC DBA BAART PROGRAMS NORWOOD

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Laboratory Demographics

CLIA Number: 05D2027724

Facility Name: BI-VALLEY MEDICAL CLINIC, INC DBA BAART PROGRAMS NORWOOD

Facility Address:
310 HARRIS AVE, STE A, E, F, G
SACRAMENTO, CA
ZIP 95838
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Facility Phone Number: 916 649-6793

Facility Type: Other - NARCOTIC TREATMENT

Certificate Type: Waiver

NPI Number: 1174544092

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	05D2027724
LAB Type	Other - NARCOTIC TREATMENT
Facility Name	BI-VALLEY MEDICAL CLINIC, INC DBA BAART PROGRAMS NORWOOD
Street	310 HARRIS AVE, STE A, E, F, G
City	SACRAMENTO
State	CA
ZIP	95838
Phone	916 649-6793
CertificateType	4
CertificateEffectiveDate	7/29/2023
CertificateExpirationDate	7/28/2025
FacilityType	Waiver

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