05D2273661 CLIA NUMBER - COMMUNITY HEALTH CENTERS OF AMERICA

Laboratory Demographics

CLIA Number: 05D2273661

Facility Name: COMMUNITY HEALTH CENTERS OF AMERICA

Facility Address:
5723 MARCONI AVE SUITE A
CARMICHAEL, CA
ZIP 95608
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Facility Phone Number: 209 445-2388

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1891207684

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2273661
LAB Type	Federally Qualified Health Center
Facility Name	COMMUNITY HEALTH CENTERS OF AMERICA
Street	5723 MARCONI AVE SUITE A
City	CARMICHAEL
State	CA
ZIP	95608
Phone	209 445-2388
CertificateType	4
CertificateEffectiveDate	12/16/2022
CertificateExpirationDate	12/15/2024
FacilityType	Waiver

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