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05D2132014 CLIA NUMBER - DAP HEALTH - SAN JACINTO COMMUNITY HEALTH CENTER

Laboratory Demographics

CLIA Number: 05D2132014

Facility Name: DAP HEALTH - SAN JACINTO COMMUNITY HEALTH CENTER

Facility Address:
651 N STATE ST, STE 5
SAN JACINTO, CA
ZIP 92583
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Facility Phone Number: 760 323-2118

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver
NPI Number: 1548311897

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 05D2132014
LAB Type Federally Qualified Health Center
Facility Name DAP HEALTH - SAN JACINTO COMMUNITY HEALTH CENTER
Street 651 N STATE ST, STE 5
City SAN JACINTO
State CA
ZIP 92583
Phone 760 323-2118
CertificateType 4
CertificateEffectiveDate 6/9/2023
CertificateExpirationDate 6/8/2025
FacilityType Waiver

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