Organization
SHOSHONE PAIUTE TRIBES
Active
Other names
Owyhee Community Health Facility Labratory
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY MARSHALL (TRIBAL HEALTH ADMINISTRATOR)
(775) 757-2415
Entity
Organization
Contact information
Practice address
1623 HOSPITAL LOOP, OWYHEE, NV 89832-1200
(775) 757-2415
(775) 757-2066
Mailing address
PO BOX 130, 1623 HOSPITAL LOOP ROAD, OWYHEE, NV 89832
(775) 757-2415
(775) 757-2066
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29D0697857
CLIA
NV
Enumeration date
08/18/2014
Last updated
08/18/2014
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