05D0916779 CLIA NUMBER - SAN JACINTO FAMILY & URGENT CARE

Laboratory Demographics

CLIA Number: 05D0916779

Facility Name: SAN JACINTO FAMILY & URGENT CARE

Facility Address:
229 W 7TH ST
SAN JACINTO, CA
ZIP 92583
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Facility Phone Number: 951 487-2550

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477647386

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0916779
LAB Type	Physician Office
Facility Name	SAN JACINTO FAMILY & URGENT CARE
Street	229 W 7TH ST
City	SAN JACINTO
State	CA
ZIP	92583
Phone	951 487-2550
CertificateType	4
CertificateEffectiveDate	9/16/2023
CertificateExpirationDate	9/15/2025
FacilityType	Waiver

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