05D0562214 CLIA NUMBER - MY FAMILY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0562214
  • Facility Name: MY FAMILY MEDICAL GROUP
  • Facility Address: 5475 WALNUT AVE
    CHINO, CA
    ZIP 91710
  • Facility Phone: 909 287-7418
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE LIRA
  • NPI Number: 1790730786
  • Taxonomy: 302R00000X - Health Maintenance Organization

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CLIA Record

Field Name Field Value
CLIA Number 05D0562214
LAB Type Physician Office
Facility Name MY FAMILY MEDICAL GROUP
Street 5475 WALNUT AVE
City CHINO
State CA
ZIP 91710
Phone 909 287-7418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Physician Office
Lab Director JOSE LIRA

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