05D0866355 CLIA NUMBER - CALIFORNIA INSTITUTION FOR MEN HOSPITAL LABORATORY

Laboratory Demographics

  • CLIA Code: 05D0866355
  • Facility Name: CALIFORNIA INSTITUTION FOR MEN HOSPITAL LABORATORY
  • Facility Address: 14901 S CENTRAL AVE
    CHINO, CA
    ZIP 91710
  • Facility Phone: 909 597-1821
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: MUHAMMAD FAROOQ
  • NPI Number: 1346667268
  • Taxonomy: 273R00000X - Psychiatric Unit

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CLIA Record

Field Name Field Value
CLIA Number 05D0866355
LAB Type Prison
Facility Name CALIFORNIA INSTITUTION FOR MEN HOSPITAL LABORATORY
Street 14901 S CENTRAL AVE
City CHINO
State CA
ZIP 91710
Phone 909 597-1821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2024
Certificate Expiration Date 8/20/2026
Facility Type Prison
Lab Director MUHAMMAD FAROOQ

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