05D0879364 CLIA NUMBER - RUBEN RUIZ, MD, A MEDICAL CORPORATION

Laboratory Demographics

CLIA Number: 05D0879364

Facility Name: RUBEN RUIZ, MD, A MEDICAL CORPORATION

Facility Address:
403 WEST F STREET
ONTARIO, CA
ZIP 91762
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Facility Phone Number: 909 988-3288

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1043241821

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0879364
LAB Type	Physician Office
Facility Name	RUBEN RUIZ, MD, A MEDICAL CORPORATION
Street	403 WEST F STREET
City	ONTARIO
State	CA
ZIP	91762
Phone	909 988-3288
CertificateType	4
CertificateEffectiveDate	10/18/2022
CertificateExpirationDate	10/17/2024
FacilityType	Waiver

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