LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.
NPI 1285000810
Clinic/Center - Federally Qualified Health Center (FQHC) in Clearlake, CA
About Lake County Tribal Health Consortium, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC. (NPI 1285000810) is a federally qualified health center (fqhc) in Clearlake, California and active in the NPI registry since August 2015. The organization holds a CLIA Microscopy certificate valid through December 16, 2026 and lists Ernesto Padilla, Executive Director, as its authorized official.Information from the official NPPES registry record, last updated April 2, 2024.
NPPES Registry Identity
★ Primary Specialty
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0722889
- Facility Type
- Other - TRIBAL/IHS JOINT VENTURE
- Certificate Effective Date
- December 17, 2024
- Certificate Expiration Date
- December 16, 2026
- Laboratory Director
- ANDRE P. LALLANDE
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Lake County Tribal Health Consortium, Inc. in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285000810, enumerated as an "organization" on August 18, 2015.
The provider is located at 14678 LAKESHORE BOULEVARD CLEARLAKE, CA 95453 and the phone number is (707) 262-8382.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
