05D2108304 CLIA NUMBER - PRIMARY CARE PRACTICE

Laboratory Demographics

  • CLIA Code: 05D2108304
  • Facility Name: PRIMARY CARE PRACTICE
  • Facility Address: 2721 OLIVE HWY STE
    OROVILLE, CA
    ZIP 95966
  • Facility Phone: 530 532-3091
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MARK T. HEINRICH DO
  • NPI Number: 1063750297
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2108304
LAB Type Rural Health Clinic
Facility Name PRIMARY CARE PRACTICE
Street 2721 OLIVE HWY STE
City OROVILLE
State CA
ZIP 95966
Phone 530 532-3091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Rural Health Clinic
Lab Director MARK T. HEINRICH DO

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