TRI-STATE COMMUNITY HEALTHCARE CENTER
NPI 1508379017
Clinic/Center - Federally Qualified Health Center (FQHC) in Adelanto, CA
NPI Status: Active since November 07, 2017
Contact Information
11499 BARTLETT AVE
ADELANTO, CA
ZIP 92301
Phone: (760) 444-4258
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 05D2285000
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 07-02-2027
About TRI-STATE COMMUNITY HEALTHCARE CENTER
This page provides the complete NPI Profile along with additional information for Tri-state Community Healthcare Center, a primary care provider established in Adelanto, California operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1508379017 assigned on November 2017. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Crystale Mineros (Credentialing Manager)
- NPI
- 1508379017
- Provider Name
- TRI-STATE COMMUNITY HEALTHCARE CENTER
- Entity Type
- Organization
- Location Address
- 11499 BARTLETT AVE ADELANTO, CA 92301
- Location Phone
- (760) 444-4258
- Mailing Address
- 1535 E COLORADO ST GLENDALE, CA 91205
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 11-07-2017
- Last Update Date
- 09-29-2025
- Code Navigator
A primary care provider (PCP) like Tri-state Community Healthcare Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 11273 Laurel Canyon Blvd Ste 2
San Fernando, CA 91340
(818) 853-2220 - 6630 Crenshaw Blvd
Los Angeles, CA 90043
(213) 686-1517 - 3600 E 1st St
Los Angeles, CA 90063
(323) 694-0911 - 540 N San Jacinto St Ste I
Hemet, CA 92543
(951) 651-1006 - 4137 Verdugo Rd
Los Angeles, CA 90065
(323) 344-9255 - 11888 Bartlett Ave
Adelanto, CA 92301
(760) 530-9944 - 540 N San Jacinto St Ste P
Hemet, CA 92543
(951) 929-4000 - 1532 San Bernardino Ave Ste B7
Pomona, CA 91767
(909) 301-4041 - 1532 San Bernardino Ave Ste A2
Pomona, CA 91767
(909) 301-4041
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center |
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
- 05D2285000
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- July 03, 2025
- Certificate Expiration Date
- July 02, 2027
- Laboratory Director
- JOSE L. PEREZ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Tri-state Community Healthcare Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1508379017, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508379017, enumerated as an "organization" on November 07, 2017.
The provider is located at 11499 BARTLETT AVE ADELANTO, CA 92301 and the phone number is (760) 444-4258.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
