05D0642889 CLIA NUMBER - FOUNDATION LABORATORY

Laboratory Demographics

  • CLIA Code: 05D0642889
  • Facility Name: FOUNDATION LABORATORY
  • Facility Address: 1716 W HOLT AVE
    POMONA, CA
    ZIP 91768
  • Facility Phone: 909 623-9301
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: SIMA FARGAHI
  • NPI Number: 1881626943
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D0642889
LAB Type Independent
Facility Name FOUNDATION LABORATORY
Street 1716 W HOLT AVE
City POMONA
State CA
ZIP 91768
Phone 909 623-9301
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Independent
Lab Director SIMA FARGAHI

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