MORONGO INDIAN HEALTH
NPI 1437202124
Clinic/Center - Federally Qualified Health Center (FQHC) in Banning, CA

Q: What is Riverside-San Bernardino County Indian 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.

Active since January 18, 2007CLIA 05D0060932 · Waiver

11555 1/2 POTRERO RD, BANNING, CA 92220(951) 849-4761(951) 849-5612 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 25, 2021, Mar 9, 2021, Oct 26, 2016 (3 updates tracked since 2016).

On this page

About Morongo Indian Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MORONGO INDIAN HEALTH (NPI 1437202124) is a healthcare organization registered as a federally qualified health center (fqhc) in Banning, California and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through February 28, 2027 and lists William Thomsen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1437202124

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameRIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC

Location Address11555 1/2 POTRERO RDBanning, CA 92220-6946

Mailing Address11980 Mount Vernon AveGrand Terrace, CA 92313-5172 · (909) 864-1097 · Fax (909) 744-3960

Phone(951) 849-4761

Fax(951) 849-5612

Organization SubpartNo

Authorized OfficialWilliam ThomsenCeo · (909) 864-1097

Enumeration DateJanuary 18, 2007

Last NPPES UpdateAugust 25, 20213 updates tracked since enumeration

NPPES CertifiedAugust 25, 2021

✔ NPI 1437202124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

11555 1/2 POTRERO RD, Banning, CA 92220

Open in Google Maps ↗

Other Names 1

Doing Business AsMorongo Indian Health

Other Identifiers 1

MedicaidFHC03854FCA

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 05D0060932

Morongo Indian Health Center · Banning, CA

Active · expires Feb 28, 2027

CLIA Number05D0060932

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateMarch 1, 2025

Certificate Expiration DateFebruary 28, 2027

Laboratory DirectorPhilip T. Farabaugh

Laboratory Phone(800) 732-8805

Laboratory LocationMorongo Indian Health Center11555 1/2 Potrero Road, Banning, CA 92220

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER MERCER PSYD, DRPH

Psychologist (Health Service)