05D0891510 CLIA NUMBER - CALIFORNIA REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 05D0891510
  • Facility Name: CALIFORNIA REHABILITATION CENTER
  • Facility Address: 5TH & WESTERN
    NORCO, CA
    ZIP 92860
  • Facility Phone: 909 737-2683
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: KENNETH L. MAXWELL, DO
  • NPI Number: 1780188482
  • Taxonomy: 207NS0135X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0891510
LAB Type Prison
Facility Name CALIFORNIA REHABILITATION CENTER
Street 5TH & WESTERN
City NORCO
State CA
ZIP 92860
Phone 909 737-2683
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Prison
Lab Director KENNETH L. MAXWELL, DO

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