05D0865794 CLIA NUMBER - HEMET VALLEY HEALTHCARE CENTER LABORATORY

Laboratory Demographics

CLIA Number: 05D0865794

Facility Name: HEMET VALLEY HEALTHCARE CENTER LABORATORY

Facility Address:
1117 E DEVONSHIRE AVENUE
HEMET, CA
ZIP 92543
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Facility Phone Number: 951 927-4127

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1558337444

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0865794
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	HEMET VALLEY HEALTHCARE CENTER LABORATORY
Street	1117 E DEVONSHIRE AVENUE
City	HEMET
State	CA
ZIP	92543
Phone	951 927-4127
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024