05D0575334 CLIA NUMBER - RIVERSIDE SANITARIUM LLC DBA COUNTRY VILLA RIVERSIDE HEALTHCARE CENTER

Laboratory Demographics

  • CLIA Code: 05D0575334
  • Facility Name: RIVERSIDE SANITARIUM LLC DBA COUNTRY VILLA RIVERSIDE HEALTHCARE CENTER
  • Facility Address: 4580 PALM AVENUE
    RIVERSIDE, CA
    ZIP 92501
  • Facility Phone: 951 684-7701
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SARABJIT SANDU
  • NPI Number: 1245224732
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 05D0575334
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RIVERSIDE SANITARIUM LLC DBA COUNTRY VILLA RIVERSIDE HEALTHCARE CENTER
Street 4580 PALM AVENUE
City RIVERSIDE
State CA
ZIP 92501
Phone 951 684-7701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SARABJIT SANDU

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This page was last updated on: 3/20/2025