05D0895863 CLIA NUMBER - CHAPARRAL MEDICAL GROUP, INC

Laboratory Demographics

CLIA Number: 05D0895863

Facility Name: CHAPARRAL MEDICAL GROUP, INC

Facility Address:
1904 N ORANGE GROVE
POMONA, CA
ZIP 91767
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Facility Phone Number: 909 469-1823

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1114989241

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	05D0895863
LAB Type	Physician Office
Facility Name	CHAPARRAL MEDICAL GROUP, INC
Street	1904 N ORANGE GROVE
City	POMONA
State	CA
ZIP	91767
Phone	909 469-1823
CertificateType	4
CertificateEffectiveDate	10/23/2023
CertificateExpirationDate	10/22/2025
FacilityType	Waiver

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