05D0675174 CLIA NUMBER - BEAVER MEDICAL GROUP LP OASIS PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D0675174
  • Facility Name: BEAVER MEDICAL GROUP LP OASIS PEDIATRICS
  • Facility Address: 1690 BARTON RD, STE 104
    REDLANDS, CA
    ZIP 92373
  • Facility Phone: 909 786-0844
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VARONICA DIXON
  • NPI Number: 1144265919
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 05D0675174
LAB Type Physician Office
Facility Name BEAVER MEDICAL GROUP LP OASIS PEDIATRICS
Street 1690 BARTON RD, STE 104
City REDLANDS
State CA
ZIP 92373
Phone 909 786-0844
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director VARONICA DIXON

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