29D0703165 CLIA NUMBER - PYRAMID LAKE TRIBAL HEALTH CLINIC

Laboratory Demographics

CLIA Number: 29D0703165

Facility Name: PYRAMID LAKE TRIBAL HEALTH CLINIC

Facility Address:
705 HWY 446
NIXON, NV
ZIP 89424
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Facility Phone Number: 775 574-1018

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1871972661

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	29D0703165
LAB Type	Federally Qualified Health Center
Facility Name	PYRAMID LAKE TRIBAL HEALTH CLINIC
Street	705 HWY 446
City	NIXON
State	NV
ZIP	89424
Phone	775 574-1018
CertificateType	4
CertificateEffectiveDate	4/26/2023
CertificateExpirationDate	4/25/2025
FacilityType	Waiver

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