05D0060416 CLIA NUMBER - STUDENT HEALTH SERVICES LAB CAL STATE POLY UNIVERSITY POMONA

Laboratory Demographics

  • CLIA Code: 05D0060416
  • Facility Name: STUDENT HEALTH SERVICES LAB CAL STATE POLY UNIVERSITY POMONA
  • Facility Address: 3801 W TEMPLE AVE, BLDG 46
    POMONA, CA
    ZIP 91768
  • Facility Phone: 909 869-3218
  • Facility Type: School/Student Health Service
  • Facility Type: Accreditation
  • Lab Director: DR. TANIA I. MEDINA
  • NPI Number: 1932396512
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0060416
LAB Type School/Student Health Service
Facility Name STUDENT HEALTH SERVICES LAB CAL STATE POLY UNIVERSITY POMONA
Street 3801 W TEMPLE AVE, BLDG 46
City POMONA
State CA
ZIP 91768
Phone 909 869-3218
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type School/Student Health Service
Lab Director DR. TANIA I. MEDINA

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This page was last updated on: 9/29/2025