05D0722407 CLIA NUMBER - RAVINDRANATH V SHAHANE, MD

Laboratory Demographics

  • CLIA Code: 05D0722407
  • Facility Name: RAVINDRANATH V SHAHANE, MD
  • Facility Address: 1734 N RIVERSIDE AVE STE 2
    RIALTO, CA
    ZIP 92376
  • Facility Phone: 909 875-3595
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAVINDRANATH V. SHAHANE, MD
  • NPI Number: 1457420903
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0722407
LAB Type Physician Office
Facility Name RAVINDRANATH V SHAHANE, MD
Street 1734 N RIVERSIDE AVE STE 2
City RIALTO
State CA
ZIP 92376
Phone 909 875-3595
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Physician Office
Lab Director RAVINDRANATH V. SHAHANE, MD

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