05D2171290 CLIA NUMBER - PREMIER HEALTH PRACTICE

Laboratory Demographics

CLIA Number: 05D2171290

Facility Name: PREMIER HEALTH PRACTICE

Facility Address:
3579 ORO DAM ROAD
OROVILLE, CA
ZIP 95966
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Facility Phone Number: 530 532-8321

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1659849529

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2171290
LAB Type	Community Clinic
Facility Name	PREMIER HEALTH PRACTICE
Street	3579 ORO DAM ROAD
City	OROVILLE
State	CA
ZIP	95966
Phone	530 532-8321
CertificateType	4
CertificateEffectiveDate	8/28/2023
CertificateExpirationDate	8/27/2025
FacilityType	Waiver

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