05D0876601 CLIA NUMBER - INLAND REGION MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D0876601
  • Facility Name: INLAND REGION MEDICAL GROUP
  • Facility Address: 9089 BASELINE ROAD, SUITE 100-A
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Facility Phone: 909 625-4846
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES M. HALLY DO
  • NPI Number: 1083724850
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0876601
LAB Type Physician Office
Facility Name INLAND REGION MEDICAL GROUP
Street 9089 BASELINE ROAD, SUITE 100-A
City RANCHO CUCAMONGA
State CA
ZIP 91730
Phone 909 625-4846
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2025
Certificate Expiration Date 9/19/2027
Facility Type Physician Office
Lab Director JAMES M. HALLY DO

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