SOUTHERN TRINITY HEALTH INC
NPI 1053595744
Clinic/Center - Federally Qualified Health Center (FQHC) in Mad River, CA
About Southern Trinity Health Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN TRINITY HEALTH INC (NPI 1053595744) is a healthcare organization registered as a federally qualified health center (fqhc) in Mad River, California and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through November 15, 2026 and lists Graylan Lupton, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D0613049
Southern Trinity Health Services Inc · Mad River, CAOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MAD RIVER, CA 95552
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southern Trinity Health Inc's NPI number?
The NPI number for Southern Trinity Health Inc is 1053595744. It was assigned to this organization in the NPPES registry on December 18, 2007.
Where is Southern Trinity Health Inc located?
Southern Trinity Health Inc is located at 153-A Van Duzen Rd, Mad River, CA 95552. The listed phone number is (707) 574-6616.
What is Southern Trinity Health Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Does Southern Trinity Health Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0613049) is associated with this NPI, valid through November 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Southern Trinity Health Inc was last updated on April 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.
